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ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 401k Plan overview

Plan NameASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND
Plan identification number 501

ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER has sponsored the creation of one or more 401k plans.

Company Name:ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER
Employer identification number (EIN):943378739
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Additional information about ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C0771665

More information about ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01MARK R AYDELOTTE
5012011-01-01TRACY BERRY
5012009-01-01MARK R. AYDELOTTE

Plan Statistics for ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND

401k plan membership statisitcs for ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND

Measure Date Value
2022: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2022 401k membership
Total participants, beginning-of-year2022-01-011,278
Total number of active participants reported on line 7a of the Form 55002022-01-011,320
Number of retired or separated participants receiving benefits2022-01-011
Total of all active and inactive participants2022-01-011,321
2021: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2021 401k membership
Total participants, beginning-of-year2021-01-011,132
Total number of active participants reported on line 7a of the Form 55002021-01-011,275
Number of retired or separated participants receiving benefits2021-01-013
Total of all active and inactive participants2021-01-011,278
2020: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2020 401k membership
Total participants, beginning-of-year2020-01-011,194
Total number of active participants reported on line 7a of the Form 55002020-01-011,126
Number of retired or separated participants receiving benefits2020-01-016
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-011,132
2019: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2019 401k membership
Total participants, beginning-of-year2019-01-01692
Total number of active participants reported on line 7a of the Form 55002019-01-01871
Number of retired or separated participants receiving benefits2019-01-010
Total of all active and inactive participants2019-01-01871
2018: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2018 401k membership
Total participants, beginning-of-year2018-01-01742
Total number of active participants reported on line 7a of the Form 55002018-01-01830
Number of retired or separated participants receiving benefits2018-01-014
Total of all active and inactive participants2018-01-01834
2017: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2017 401k membership
Total participants, beginning-of-year2017-01-01446
Total number of active participants reported on line 7a of the Form 55002017-01-01439
Total of all active and inactive participants2017-01-01439
2016: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2016 401k membership
Total participants, beginning-of-year2016-01-01498
Total number of active participants reported on line 7a of the Form 55002016-01-01446
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01446
2015: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2015 401k membership
Total participants, beginning-of-year2015-01-01535
Total number of active participants reported on line 7a of the Form 55002015-01-01497
Number of retired or separated participants receiving benefits2015-01-011
Total of all active and inactive participants2015-01-01498
2014: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2014 401k membership
Total participants, beginning-of-year2014-01-01656
Total number of active participants reported on line 7a of the Form 55002014-01-01535
Total of all active and inactive participants2014-01-01535
2013: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2013 401k membership
Total participants, beginning-of-year2013-01-01645
Total number of active participants reported on line 7a of the Form 55002013-01-01654
Number of retired or separated participants receiving benefits2013-01-012
Total of all active and inactive participants2013-01-01656
2012: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2012 401k membership
Total participants, beginning-of-year2012-01-01641
Total number of active participants reported on line 7a of the Form 55002012-01-01639
Number of retired or separated participants receiving benefits2012-01-016
Total of all active and inactive participants2012-01-01645
2011: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2011 401k membership
Total participants, beginning-of-year2011-01-01522
Total number of active participants reported on line 7a of the Form 55002011-01-01641
Number of retired or separated participants receiving benefits2011-01-010
Total of all active and inactive participants2011-01-01641
2009: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2009 401k membership
Total participants, beginning-of-year2009-01-01503
Total number of active participants reported on line 7a of the Form 55002009-01-01516
Number of retired or separated participants receiving benefits2009-01-013
Total of all active and inactive participants2009-01-01519

Financial Data on ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND

Measure Date Value
2022 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$1,153,866
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$1,149,859
Total income from all sources (including contributions)2022-12-31$11,663,509
Total of all expenses incurred2022-12-31$11,420,717
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$10,138,983
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$11,896,523
Value of total assets at end of year2022-12-31$5,588,619
Value of total assets at beginning of year2022-12-31$5,341,820
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$1,281,734
Total interest from all sources2022-12-31$1,647
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$34,855
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$34,855
Administrative expenses professional fees incurred2022-12-31$181,128
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$9,493
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$88,337
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$2,933,436
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$2,388,247
Administrative expenses (other) incurred2022-12-31$801,518
Liabilities. Value of operating payables at end of year2022-12-31$133,552
Liabilities. Value of operating payables at beginning of year2022-12-31$217,882
Total non interest bearing cash at end of year2022-12-31$859,693
Total non interest bearing cash at beginning of year2022-12-31$653,407
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$242,792
Value of net assets at end of year (total assets less liabilities)2022-12-31$4,434,753
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$4,191,961
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$6,052
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$1,782,602
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$2,021,373
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$12,888
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$14,827
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$14,827
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$1,647
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$10,050,646
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-269,516
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$11,887,030
Employer contributions (assets) at beginning of year2022-12-31$263,966
Contract administrator fees2022-12-31$293,036
Liabilities. Value of benefit claims payable at end of year2022-12-31$1,020,314
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$931,977
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MOSS ADAMS LLP
Accountancy firm EIN2022-12-31910189318
2021 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$1,149,859
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$1,266,808
Total income from all sources (including contributions)2021-12-31$9,183,038
Total of all expenses incurred2021-12-31$8,363,153
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$7,401,899
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$8,963,005
Value of total assets at end of year2021-12-31$5,341,820
Value of total assets at beginning of year2021-12-31$4,638,884
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$961,254
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$32,435
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$32,435
Administrative expenses professional fees incurred2021-12-31$134,596
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$61,286
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$-289,481
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$2,388,247
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$1,593,127
Administrative expenses (other) incurred2021-12-31$599,987
Liabilities. Value of operating payables at end of year2021-12-31$217,882
Liabilities. Value of operating payables at beginning of year2021-12-31$45,350
Total non interest bearing cash at end of year2021-12-31$653,407
Total non interest bearing cash at beginning of year2021-12-31$841,404
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$819,885
Value of net assets at end of year (total assets less liabilities)2021-12-31$4,191,961
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$3,372,076
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$6,297
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$2,021,373
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$1,805,469
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$14,827
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$16,736
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$16,736
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$7,691,380
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$187,598
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$8,901,719
Employer contributions (assets) at end of year2021-12-31$263,966
Employer contributions (assets) at beginning of year2021-12-31$382,148
Contract administrator fees2021-12-31$220,374
Liabilities. Value of benefit claims payable at end of year2021-12-31$931,977
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$1,221,458
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31MOSS ADAMS LLP
Accountancy firm EIN2021-12-31910189318
2020 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$1,266,808
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$1,317,124
Total income from all sources (including contributions)2020-12-31$8,756,472
Total of all expenses incurred2020-12-31$7,745,652
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$6,927,057
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$8,550,035
Value of total assets at end of year2020-12-31$4,638,884
Value of total assets at beginning of year2020-12-31$3,678,380
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$818,595
Total interest from all sources2020-12-31$93
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$26,237
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$26,237
Administrative expenses professional fees incurred2020-12-31$31,180
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$30,476
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$-98,009
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$1,593,127
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$741,603
Administrative expenses (other) incurred2020-12-31$562,803
Liabilities. Value of operating payables at end of year2020-12-31$111,350
Liabilities. Value of operating payables at beginning of year2020-12-31$63,657
Total non interest bearing cash at end of year2020-12-31$841,404
Total non interest bearing cash at beginning of year2020-12-31$988,724
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,010,820
Value of net assets at end of year (total assets less liabilities)2020-12-31$3,372,076
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,361,256
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$1,805,469
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$1,602,224
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$16,736
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$19,059
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$19,059
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$93
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$7,025,066
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$180,107
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$8,519,559
Employer contributions (assets) at end of year2020-12-31$382,148
Employer contributions (assets) at beginning of year2020-12-31$326,770
Contract administrator fees2020-12-31$224,612
Liabilities. Value of benefit claims payable at end of year2020-12-31$1,155,458
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$1,253,467
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31MOSS ADAMS LLP
Accountancy firm EIN2020-12-31910189318
2019 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,317,124
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,317,124
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,562,778
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,562,778
Total income from all sources (including contributions)2019-12-31$7,722,145
Total income from all sources (including contributions)2019-12-31$7,722,145
Total of all expenses incurred2019-12-31$7,023,866
Total of all expenses incurred2019-12-31$7,023,866
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$6,179,283
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$6,179,283
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$7,461,721
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$7,461,721
Value of total assets at end of year2019-12-31$3,678,380
Value of total assets at end of year2019-12-31$3,678,380
Value of total assets at beginning of year2019-12-31$3,225,755
Value of total assets at beginning of year2019-12-31$3,225,755
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$844,583
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$844,583
Total interest from all sources2019-12-31$27
Total interest from all sources2019-12-31$27
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$4,222
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$4,222
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$4,222
Administrative expenses professional fees incurred2019-12-31$155,114
Administrative expenses professional fees incurred2019-12-31$155,114
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$30,292
Contributions received from participants2019-12-31$30,292
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$-241,737
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$-241,737
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$741,603
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$741,603
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$316,316
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$316,316
Administrative expenses (other) incurred2019-12-31$525,977
Administrative expenses (other) incurred2019-12-31$525,977
Liabilities. Value of operating payables at end of year2019-12-31$63,657
Liabilities. Value of operating payables at end of year2019-12-31$63,657
Liabilities. Value of operating payables at beginning of year2019-12-31$67,574
Liabilities. Value of operating payables at beginning of year2019-12-31$67,574
Total non interest bearing cash at end of year2019-12-31$988,724
Total non interest bearing cash at end of year2019-12-31$988,724
Total non interest bearing cash at beginning of year2019-12-31$251,202
Total non interest bearing cash at beginning of year2019-12-31$251,202
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$698,279
Value of net income/loss2019-12-31$698,279
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,361,256
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,361,256
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,662,977
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,662,977
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$1,602,224
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$1,602,224
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,352,784
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,352,784
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$19,059
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$19,059
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$968,819
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$968,819
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$968,819
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$968,819
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$27
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$27
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$6,421,020
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$6,421,020
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$256,175
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$256,175
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$7,431,429
Contributions received in cash from employer2019-12-31$7,431,429
Employer contributions (assets) at end of year2019-12-31$326,770
Employer contributions (assets) at end of year2019-12-31$326,770
Employer contributions (assets) at beginning of year2019-12-31$336,634
Employer contributions (assets) at beginning of year2019-12-31$336,634
Contract administrator fees2019-12-31$163,492
Contract administrator fees2019-12-31$163,492
Liabilities. Value of benefit claims payable at end of year2019-12-31$1,253,467
Liabilities. Value of benefit claims payable at end of year2019-12-31$1,253,467
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,495,204
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,495,204
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31MOSS ADAMS LLP
Accountancy firm name2019-12-31MOSS ADAMS LLP
Accountancy firm EIN2019-12-31910189318
Accountancy firm EIN2019-12-31910189318
2018 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-61,914
Total unrealized appreciation/depreciation of assets2018-12-31$-61,914
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$1,562,778
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$1,947,003
Total income from all sources (including contributions)2018-12-31$8,098,699
Total of all expenses incurred2018-12-31$7,802,162
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$6,854,823
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$8,156,889
Value of total assets at end of year2018-12-31$3,225,755
Value of total assets at beginning of year2018-12-31$3,313,443
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$947,339
Total interest from all sources2018-12-31$1,202
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$2,522
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$2,522
Administrative expenses professional fees incurred2018-12-31$204,341
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$38,045
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$-113,174
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$316,316
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$194,404
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$321,133
Administrative expenses (other) incurred2018-12-31$565,071
Liabilities. Value of operating payables at end of year2018-12-31$67,574
Liabilities. Value of operating payables at beginning of year2018-12-31$73,992
Total non interest bearing cash at end of year2018-12-31$251,202
Total non interest bearing cash at beginning of year2018-12-31$1,382,837
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$296,537
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,662,977
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,366,440
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$3,989
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$1,352,784
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$1,423,923
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$968,819
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$9,794
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$9,794
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$1,202
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$6,967,997
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$8,118,844
Employer contributions (assets) at end of year2018-12-31$336,634
Employer contributions (assets) at beginning of year2018-12-31$302,485
Contract administrator fees2018-12-31$173,938
Liabilities. Value of benefit claims payable at end of year2018-12-31$1,495,204
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$1,551,878
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31MOSS ADAMS LLP
Accountancy firm EIN2018-12-31910189318
2017 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,947,003
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,326,465
Total income from all sources (including contributions)2017-12-31$5,557,985
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$5,333,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$4,674,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$5,386,364
Value of total assets at end of year2017-12-31$3,313,443
Value of total assets at beginning of year2017-12-31$2,468,264
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$659,103
Total interest from all sources2017-12-31$171,621
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$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$39,773
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$272,400
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$194,404
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$20
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$321,133
Administrative expenses (other) incurred2017-12-31$659,103
Liabilities. Value of operating payables at end of year2017-12-31$73,992
Liabilities. Value of operating payables at beginning of year2017-12-31$97,187
Total non interest bearing cash at end of year2017-12-31$1,382,837
Total non interest bearing cash at beginning of year2017-12-31$659,341
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$224,641
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,366,440
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,141,799
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$1,423,923
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$1,262,286
Interest earned on other investments2017-12-31$171,621
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$9,794
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$222,425
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$222,425
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$4,401,841
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$5,346,591
Employer contributions (assets) at end of year2017-12-31$302,485
Employer contributions (assets) at beginning of year2017-12-31$324,192
Liabilities. Value of benefit claims payable at end of year2017-12-31$1,551,878
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$1,229,278
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 name2017-12-31MOSS ADAMS LLP
Accountancy firm EIN2017-12-31910189318
2016 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,326,465
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$960,256
Total income from all sources (including contributions)2016-12-31$4,782,329
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$4,963,364
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$4,151,764
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$4,692,559
Value of total assets at end of year2016-12-31$2,468,264
Value of total assets at beginning of year2016-12-31$2,283,090
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$811,600
Total interest from all sources2016-12-31$26,556
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$164,385
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$39,317
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$20
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$20
Administrative expenses (other) incurred2016-12-31$332,407
Liabilities. Value of operating payables at end of year2016-12-31$97,187
Liabilities. Value of operating payables at beginning of year2016-12-31$63,385
Total non interest bearing cash at end of year2016-12-31$659,341
Total non interest bearing cash at beginning of year2016-12-31$80,376
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-181,035
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,141,799
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,322,834
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$1,262,286
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$1,180,896
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$222,425
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$790,521
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$790,521
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$26,556
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$4,151,764
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$63,214
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$4,653,242
Employer contributions (assets) at end of year2016-12-31$324,192
Employer contributions (assets) at beginning of year2016-12-31$230,757
Contract administrator fees2016-12-31$314,808
Liabilities. Value of benefit claims payable at end of year2016-12-31$1,229,278
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$896,871
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$520
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2016-12-31410746749
2015 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$960,256
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$843,478
Total income from all sources (including contributions)2015-12-31$5,537,037
Total of all expenses incurred2015-12-31$5,543,689
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$5,030,562
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$5,538,386
Value of total assets at end of year2015-12-31$2,283,090
Value of total assets at beginning of year2015-12-31$2,172,964
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$513,127
Total interest from all sources2015-12-31$5,112
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$18,130
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$18,130
Administrative expenses professional fees incurred2015-12-31$163,163
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$3,486
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$20
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$20
Administrative expenses (other) incurred2015-12-31$281,015
Liabilities. Value of operating payables at end of year2015-12-31$63,385
Liabilities. Value of operating payables at beginning of year2015-12-31$37,237
Total non interest bearing cash at end of year2015-12-31$80,376
Total non interest bearing cash at beginning of year2015-12-31$1,184
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-6,652
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,322,834
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,329,486
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$1,180,896
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$1,191,122
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$790,521
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$767,376
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$767,376
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$5,112
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$5,030,562
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-24,591
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$5,534,900
Employer contributions (assets) at end of year2015-12-31$230,757
Employer contributions (assets) at beginning of year2015-12-31$212,684
Contract administrator fees2015-12-31$68,949
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$896,871
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$806,241
Assets. Value of buildings and other operty used in plan operation at end of year2015-12-31$520
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-12-31$578
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31GALLINA LLP
Accountancy firm EIN2015-12-31942147510
2014 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$843,478
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$961,913
Total income from all sources (including contributions)2014-12-31$5,907,479
Total of all expenses incurred2014-12-31$5,979,978
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$5,705,297
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$5,903,520
Value of total assets at end of year2014-12-31$2,172,964
Value of total assets at beginning of year2014-12-31$2,363,898
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$274,681
Total interest from all sources2014-12-31$12,837
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$949
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$949
Administrative expenses professional fees incurred2014-12-31$150,888
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$8,586
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$3,617
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$20
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$152
Administrative expenses (other) incurred2014-12-31$40,541
Liabilities. Value of operating payables at end of year2014-12-31$37,237
Liabilities. Value of operating payables at beginning of year2014-12-31$21,286
Total non interest bearing cash at end of year2014-12-31$1,184
Total non interest bearing cash at beginning of year2014-12-31$1,396
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-72,499
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,329,486
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,401,985
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$1,191,122
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$767,376
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$2,113,891
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$2,113,891
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$12,837
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$5,701,680
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$-9,827
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$5,894,934
Employer contributions (assets) at end of year2014-12-31$212,684
Employer contributions (assets) at beginning of year2014-12-31$247,894
Contract administrator fees2014-12-31$83,252
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$806,241
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$940,627
Assets. Value of buildings and other operty used in plan operation at end of year2014-12-31$578
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-12-31$565
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31GALLINA LLP
Accountancy firm EIN2014-12-31942147510
2013 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$961,913
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$996,053
Total income from all sources (including contributions)2013-12-31$6,590,073
Total of all expenses incurred2013-12-31$6,595,975
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$6,103,433
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$6,575,141
Value of total assets at end of year2013-12-31$2,363,898
Value of total assets at beginning of year2013-12-31$2,403,940
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$492,542
Total interest from all sources2013-12-31$14,932
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$190,342
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$27,429
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$5,428
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$152
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$28
Administrative expenses (other) incurred2013-12-31$215,577
Liabilities. Value of operating payables at end of year2013-12-31$21,286
Liabilities. Value of operating payables at beginning of year2013-12-31$13,263
Total non interest bearing cash at end of year2013-12-31$1,396
Total non interest bearing cash at beginning of year2013-12-31$2,991
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-5,902
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,401,985
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,407,887
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$2,113,891
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$2,128,382
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$2,128,382
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$14,932
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$6,098,005
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$6,547,712
Employer contributions (assets) at end of year2013-12-31$247,894
Employer contributions (assets) at beginning of year2013-12-31$272,009
Contract administrator fees2013-12-31$86,623
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$940,627
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$982,790
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$565
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$530
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31GALLINA LLP
Accountancy firm EIN2013-12-31942147510
2012 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$996,053
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$849,661
Total income from all sources (including contributions)2012-12-31$6,128,559
Total of all expenses incurred2012-12-31$6,008,275
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$5,473,066
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$6,119,801
Value of total assets at end of year2012-12-31$2,403,940
Value of total assets at beginning of year2012-12-31$2,137,264
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$535,209
Total interest from all sources2012-12-31$8,758
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$108,104
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$62,848
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$5,080
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$28
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$23
Administrative expenses (other) incurred2012-12-31$341,115
Liabilities. Value of operating payables at end of year2012-12-31$13,263
Liabilities. Value of operating payables at beginning of year2012-12-31$17,557
Total non interest bearing cash at end of year2012-12-31$2,991
Total non interest bearing cash at beginning of year2012-12-31$11,184
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$120,284
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,407,887
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,287,603
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$2,128,382
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$1,866,112
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$1,866,112
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$8,758
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$5,467,986
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$6,056,953
Employer contributions (assets) at end of year2012-12-31$272,009
Employer contributions (assets) at beginning of year2012-12-31$259,356
Contract administrator fees2012-12-31$85,990
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$982,790
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$832,104
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$530
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$589
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31GALLINA LLP
Accountancy firm EIN2012-12-31942147510
2011 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$849,661
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$704,088
Total income from all sources (including contributions)2011-12-31$5,272,418
Total of all expenses incurred2011-12-31$5,277,342
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$4,730,905
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$5,257,430
Value of total assets at end of year2011-12-31$2,137,264
Value of total assets at beginning of year2011-12-31$1,996,615
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$546,437
Total interest from all sources2011-12-31$14,988
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$140,200
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$78,699
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$5,204
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$23
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$190
Administrative expenses (other) incurred2011-12-31$327,712
Liabilities. Value of operating payables at end of year2011-12-31$17,557
Liabilities. Value of operating payables at beginning of year2011-12-31$24,118
Total non interest bearing cash at end of year2011-12-31$11,184
Total non interest bearing cash at beginning of year2011-12-31$6,976
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-4,924
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,287,603
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,292,527
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$1,866,112
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$1,771,277
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$1,771,277
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$14,988
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$4,725,701
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$5,178,731
Employer contributions (assets) at end of year2011-12-31$259,356
Employer contributions (assets) at beginning of year2011-12-31$204,614
Contract administrator fees2011-12-31$78,525
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$832,104
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$679,970
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$589
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$13,558
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31GALLINA LLP
Accountancy firm EIN2011-12-31942147510
2010 : ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$704,088
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$737,513
Total income from all sources (including contributions)2010-12-31$4,421,800
Total of all expenses incurred2010-12-31$4,575,405
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$4,267,267
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$4,403,047
Value of total assets at end of year2010-12-31$1,996,615
Value of total assets at beginning of year2010-12-31$2,183,645
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$308,138
Total interest from all sources2010-12-31$18,753
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$130,797
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$132,419
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$5,627
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$190
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$217
Administrative expenses (other) incurred2010-12-31$109,949
Liabilities. Value of operating payables at end of year2010-12-31$24,118
Liabilities. Value of operating payables at beginning of year2010-12-31$20,812
Total non interest bearing cash at end of year2010-12-31$6,976
Total non interest bearing cash at beginning of year2010-12-31$2,985
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-153,605
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,292,527
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,446,132
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$1,771,277
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$1,958,363
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$1,958,363
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$18,753
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$4,261,640
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$4,270,628
Employer contributions (assets) at end of year2010-12-31$204,614
Employer contributions (assets) at beginning of year2010-12-31$218,364
Contract administrator fees2010-12-31$67,392
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Liabilities. Value of benefit claims payable at end of year2010-12-31$679,970
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$716,701
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$13,558
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$3,716
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31GALLINA LLP
Accountancy firm EIN2010-12-31942147510

Form 5500 Responses for ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND

2022: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2022 form 5500 responses
2022-01-01Type of plan entityMulitple employer plan
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2021 form 5500 responses
2021-01-01Type of plan entityMulitple employer plan
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2020 form 5500 responses
2020-01-01Type of plan entityMulitple employer plan
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2019 form 5500 responses
2019-01-01Type of plan entityMulitple employer plan
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2018 form 5500 responses
2018-01-01Type of plan entityMulitple employer plan
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2017 form 5500 responses
2017-01-01Type of plan entityMulitple 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 planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2016 form 5500 responses
2016-01-01Type of plan entityMulitple 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 planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2015 form 5500 responses
2015-01-01Type of plan entityMulitple employer plan
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2014 form 5500 responses
2014-01-01Type of plan entityMulitple employer plan
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2013 form 5500 responses
2013-01-01Type of plan entityMulitple employer plan
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2012 form 5500 responses
2012-01-01Type of plan entityMulitple employer plan
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2011 form 5500 responses
2011-01-01Type of plan entityMulitple employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: ASSOCIATED BUILDERS AND CONTRACTORS NORTHERN CALIFORNIA CHAPTER BENEFIT TRUST FUND 2009 form 5500 responses
2009-01-01Type of plan entityMulitple employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number234263
Policy instance 6
Insurance contract or identification number234263
Number of Individuals Covered12
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $22
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,214
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees22
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number606129
Policy instance 5
Insurance contract or identification number606129
Number of Individuals Covered923
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,124
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,713,918
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2124
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0064080
Policy instance 4
Insurance contract or identification numberW0064080
Number of Individuals Covered643
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $9,270
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,754,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees9270
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0064080
Policy instance 3
Insurance contract or identification numberW0064080
Number of Individuals Covered1343
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $65,264
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: 00000 )
Policy contract number30011803
Policy instance 2
Insurance contract or identification number30011803
Number of Individuals Covered897
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number899405-000
Policy instance 1
Insurance contract or identification number899405-000
Number of Individuals Covered398
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $9,081
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $178,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees9081
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number606129
Policy instance 5
Insurance contract or identification number606129
Number of Individuals Covered409
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,414
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,130,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3389
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number899405-000
Policy instance 1
Insurance contract or identification number899405-000
Number of Individuals Covered508
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $11,818
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $239,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees11818
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30011803
Policy instance 2
Insurance contract or identification number30011803
Number of Individuals Covered840
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0064080
Policy instance 3
Insurance contract or identification numberW0064080
Number of Individuals Covered1205
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $63,480
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 numberW0064080
Policy instance 4
Insurance contract or identification numberW0064080
Number of Individuals Covered621
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,164,566
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: 00000 )
Policy contract number30011803
Policy instance 2
Insurance contract or identification number30011803
Number of Individuals Covered730
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number899405-000
Policy instance 1
Insurance contract or identification number899405-000
Number of Individuals Covered351
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $158,061
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 numberW0064080
Policy instance 5
Insurance contract or identification numberW0064080
Number of Individuals Covered739
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,054,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0064080
Policy instance 3
Insurance contract or identification numberW0064080
Number of Individuals Covered1084
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,274
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 number234263
Policy instance 4
Insurance contract or identification number234263
Number of Individuals Covered4
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $8
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees8
Additional information about fees paid to insurance brokerBONUS
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30011803
Policy instance 2
Insurance contract or identification number30011803
Number of Individuals Covered602
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0064080
Policy instance 4
Insurance contract or identification numberW0064080
Number of Individuals Covered931
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $58,736
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 number606129
Policy instance 5
Insurance contract or identification number606129
Number of Individuals Covered268
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,629
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $950,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5150
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number899405-000
Policy instance 1
Insurance contract or identification number899405-000
Number of Individuals Covered198
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,937
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 numberW0064080
Policy instance 3
Insurance contract or identification numberW0064080
Number of Individuals Covered739
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,684,083
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0064080
Policy instance 4
Insurance contract or identification numberW0064080
Number of Individuals Covered553
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $35,767
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: 00000 )
Policy contract number30011803
Policy instance 2
Insurance contract or identification number30011803
Number of Individuals Covered754
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 )
Policy contract number228006
Policy instance 5
Insurance contract or identification number228006
Number of Individuals Covered30
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $119,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUDS0AI4Z
Policy instance 6
Insurance contract or identification numberGUDS0AI4Z
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number899405-000
Policy instance 1
Insurance contract or identification number899405-000
Number of Individuals Covered135
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,015
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 numberW0064080
Policy instance 3
Insurance contract or identification numberW0064080
Number of Individuals Covered1147
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,751,928
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: 00000 )
Policy contract number30011803
Policy instance 5
Insurance contract or identification number30011803
Number of Individuals Covered473
Insurance policy start date2017-01-01
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?No
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 BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AI4Z
Policy instance 4
Insurance contract or identification numberGLUG0AI4Z
Number of Individuals Covered439
Insurance policy start date2017-01-01
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?No
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $34,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUDS0AI4Z
Policy instance 3
Insurance contract or identification numberGUDS0AI4Z
Number of Individuals Covered369
Insurance policy start date2017-01-01
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?No
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 BenefitYes
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 $97,583
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number899405
Policy instance 2
Insurance contract or identification number899405
Number of Individuals Covered96
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $86
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?No
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 BenefitYes
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 $43,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $86
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE SERVICES
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0064080
Policy instance 1
Insurance contract or identification numberW0064080
Number of Individuals Covered742
Insurance policy start date2017-01-01
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?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 $4,133,056
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract numberN6349A
Policy instance 6
Insurance contract or identification numberN6349A
Number of Individuals Covered17
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,486
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $178,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,103
Insurance broker organization code?3
Insurance broker nameDC & ASSOCIATES
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract numberN6350A
Policy instance 7
Insurance contract or identification numberN6350A
Number of Individuals Covered6
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,535
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,299
Insurance broker organization code?3
Insurance broker nameDC & ASSOCIATES
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract numberN6351A
Policy instance 8
Insurance contract or identification numberN6351A
Number of Individuals Covered4
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,318
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,115
Insurance broker organization code?3
Insurance broker nameDC & ASSOCIATES
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number69809-10 A&B
Policy instance 9
Insurance contract or identification number69809-10 A&B
Number of Individuals Covered66
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,531
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $572,711
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,080
Insurance broker organization code?3
Insurance broker nameKEVIN SALTZMAN
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number602720
Policy instance 10
Insurance contract or identification number602720
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,342
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 numberN6337A & N6537A
Policy instance 11
Insurance contract or identification numberN6337A & N6537A
Number of Individuals Covered10
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,817
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,150
Insurance broker organization code?3
Insurance broker nameDC & ASSOCIATES
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000A14Z
Policy instance 12
Insurance contract or identification numberG000A14Z
Number of Individuals Covered262
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,554
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $132,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,554
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146199
Policy instance 13
Insurance contract or identification number146199
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,216
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 number69808A & 69808B
Policy instance 5
Insurance contract or identification number69808A & 69808B
Number of Individuals Covered94
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $10,823
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,107,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,291
Insurance broker organization code?3
Insurance broker nameFELICE INSURANCE
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number69807A
Policy instance 4
Insurance contract or identification number69807A
Number of Individuals Covered238
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $199,652
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,636,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $186,099
Insurance broker organization code?3
Insurance broker nameFELICE INSURANCE
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number899405
Policy instance 3
Insurance contract or identification number899405
Number of Individuals Covered32
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,655
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $77,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,085
Insurance broker organization code?3
Insurance broker nameDC & ASSOCIATES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30011803
Policy instance 2
Insurance contract or identification number30011803
Number of Individuals Covered424
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,545
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,390
Insurance broker organization code?3
Insurance broker nameDC & ASSOCIATES
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000A14Z
Policy instance 1
Insurance contract or identification numberG000A14Z
Number of Individuals Covered449
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,742
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,619
Insurance broker organization code?3
Insurance broker nameDC & ASSOCIATES
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number69087A
Policy instance 6
Insurance contract or identification number69087A
Number of Individuals Covered207
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $202,949
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,303,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $155,366
Insurance broker organization code?3
Insurance broker nameNEVIN & WITT INSURANCE & FINANCIAL
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number899405
Policy instance 5
Insurance contract or identification number899405
Number of Individuals Covered95
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,640
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $90,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,640
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000A14Z
Policy instance 4
Insurance contract or identification numberG000A14Z
Number of Individuals Covered171
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,981
Total amount of fees paid to insurance companyUSD $796
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $131,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,981
Amount paid for insurance broker fees796
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AI4Z
Policy instance 2
Insurance contract or identification numberG000AI4Z
Number of Individuals Covered486
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,673
Total amount of fees paid to insurance companyUSD $1,178
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,673
Amount paid for insurance broker fees1178
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number602720
Policy instance 1
Insurance contract or identification number602720
Number of Individuals Covered123
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $62,446
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,364,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $62,446
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30011803
Policy instance 3
Insurance contract or identification number30011803
Number of Individuals Covered413
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,391
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,391
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract numberN6349A
Policy instance 9
Insurance contract or identification numberN6349A
Number of Individuals Covered24
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $210,179
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 number69808A & 69808B
Policy instance 7
Insurance contract or identification number69808A & 69808B
Number of Individuals Covered64
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $700,156
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 number69810A & 69810B
Policy instance 8
Insurance contract or identification number69810A & 69810B
Number of Individuals Covered22
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $183,123
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 numberN6351A & N6351B
Policy instance 11
Insurance contract or identification numberN6351A & N6351B
Number of Individuals Covered10
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $200,173
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 number69809A & 69809B
Policy instance 12
Insurance contract or identification number69809A & 69809B
Number of Individuals Covered31
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $354,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146199
Policy instance 13
Insurance contract or identification number146199
Number of Individuals Covered0
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number718182-0011
Policy instance 14
Insurance contract or identification number718182-0011
Number of Individuals Covered0
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number718182-0008
Policy instance 15
Insurance contract or identification number718182-0008
Number of Individuals Covered0
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number718182-0001
Policy instance 16
Insurance contract or identification number718182-0001
Number of Individuals Covered0
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,844
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 numberN6350A
Policy instance 10
Insurance contract or identification numberN6350A
Number of Individuals Covered5
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number245092
Policy instance 10
Insurance contract or identification number245092
Number of Individuals Covered8
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number718182-0011
Policy instance 3
Insurance contract or identification number718182-0011
Number of Individuals Covered2
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,515
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 number602720
Policy instance 4
Insurance contract or identification number602720
Number of Individuals Covered141
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $65,378
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,464,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,378
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AI4Z
Policy instance 5
Insurance contract or identification numberG000AI4Z
Number of Individuals Covered524
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,676
Total amount of fees paid to insurance companyUSD $688
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,676
Amount paid for insurance broker fees688
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number718182-0008
Policy instance 7
Insurance contract or identification number718182-0008
Number of Individuals Covered20
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $16,239
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $146,955
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,239
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30011803
Policy instance 6
Insurance contract or identification number30011803
Number of Individuals Covered385
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,633
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,633
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000A14Z
Policy instance 8
Insurance contract or identification numberG000A14Z
Number of Individuals Covered246
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,658
Total amount of fees paid to insurance companyUSD $486
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,658
Amount paid for insurance broker fees486
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number718182-0001
Policy instance 9
Insurance contract or identification number718182-0001
Number of Individuals Covered6
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,327
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146681
Policy instance 2
Insurance contract or identification number146681
Number of Individuals Covered55
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $554,554
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146199 & 146680
Policy instance 1
Insurance contract or identification number146199 & 146680
Number of Individuals Covered307
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $232,588
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,325,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $178,146
Insurance broker organization code?3
Insurance broker nameSEQUOIA BENEFITS LLC
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number899405
Policy instance 11
Insurance contract or identification number899405
Number of Individuals Covered143
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,638
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,638
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number245092
Policy instance 11
Insurance contract or identification number245092
Number of Individuals Covered1
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number718182-0011
Policy instance 3
Insurance contract or identification number718182-0011
Number of Individuals Covered2
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00442443
Policy instance 4
Insurance contract or identification number00442443
Number of Individuals Covered166
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $7,789
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,789
Insurance broker nameHEFFERNAN INSURANCE BROKERS
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number602720
Policy instance 5
Insurance contract or identification number602720
Number of Individuals Covered276
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $53,975
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,197,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $53,975
Insurance broker nameHEFFERNAN INSURANCE BROKERS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AI4Z
Policy instance 6
Insurance contract or identification numberG000AI4Z
Number of Individuals Covered454
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,257
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,257
Insurance broker nameHEFFERNAN INSURANCE BROKERS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number718182-0008
Policy instance 8
Insurance contract or identification number718182-0008
Number of Individuals Covered15
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $12,244
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,244
Insurance broker nameHEFFERNAN INSURANCE BROKERS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000A14Z
Policy instance 9
Insurance contract or identification numberG000A14Z
Number of Individuals Covered232
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,645
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,645
Insurance broker nameHEFFERNAN INSURANCE BROKERS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number718182-0001
Policy instance 10
Insurance contract or identification number718182-0001
Number of Individuals Covered13
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $113,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146681
Policy instance 2
Insurance contract or identification number146681
Number of Individuals Covered84
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $795,038
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: 00000 )
Policy contract number30011803
Policy instance 7
Insurance contract or identification number30011803
Number of Individuals Covered401
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,658
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,658
Insurance broker nameHEFFERNAN INSURANCE BROKERS
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146199 & 146680
Policy instance 1
Insurance contract or identification number146199 & 146680
Number of Individuals Covered317
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $234,928
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,930,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $167,954
Insurance broker organization code?3
Insurance broker nameSEQUOIA BENEFITS LLC
PACIFICARE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70785 )
Policy contract number718182-0011
Policy instance 3
Insurance contract or identification number718182-0011
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,120
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number602720
Policy instance 5
Insurance contract or identification number602720
Number of Individuals Covered142
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $65,044
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $988,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUGOA14Z
Policy instance 6
Insurance contract or identification numberGLUGOA14Z
Number of Individuals Covered438
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,866
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,748
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: 00000 )
Policy contract number30011803
Policy instance 7
Insurance contract or identification number30011803
Number of Individuals Covered401
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,144
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number718182-0008
Policy instance 8
Insurance contract or identification number718182-0008
Number of Individuals Covered23
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUDSOA14Z
Policy instance 9
Insurance contract or identification numberGUDSOA14Z
Number of Individuals Covered209
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,449
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,987
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFICARE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70785 )
Policy contract number718182-0001
Policy instance 10
Insurance contract or identification number718182-0001
Number of Individuals Covered16
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $137,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146680 & 146199
Policy instance 1
Insurance contract or identification number146680 & 146199
Number of Individuals Covered278
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $164,117
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,482,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146681
Policy instance 2
Insurance contract or identification number146681
Number of Individuals Covered88
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $31,607
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $641,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00442443
Policy instance 4
Insurance contract or identification number00442443
Number of Individuals Covered187
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $10,830
Total amount of fees paid to insurance companyUSD $5,151
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $154,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146681
Policy instance 2
Insurance contract or identification number146681
Number of Individuals Covered78
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $34,066
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $634,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,066
Insurance broker organization code?3
Insurance broker nameKEVIN SALTZMAN
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number146680 & 146199
Policy instance 1
Insurance contract or identification number146680 & 146199
Number of Individuals Covered258
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $163,813
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,561,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $159,836
Insurance broker organization code?3
Insurance broker nameNEVINS FINANCIAL SERVICES
PACIFICARE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70785 )
Policy contract number10018-004
Policy instance 3
Insurance contract or identification number10018-004
Number of Individuals Covered4
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,015
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,616
Insurance broker organization code?3
Insurance broker nameHEFFERNAN INSURANCE BROKERS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00442443
Policy instance 5
Insurance contract or identification number00442443
Number of Individuals Covered154
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $6,603
Total amount of fees paid to insurance companyUSD $5,303
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $95,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,764
Amount paid for insurance broker fees5303
Insurance broker organization code?3
Insurance broker name
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0710666
Policy instance 4
Insurance contract or identification number0710666
Number of Individuals Covered218
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,768
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,765
Insurance broker organization code?3
Insurance broker nameKEVIN SALTZMAN
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number602720
Policy instance 6
Insurance contract or identification number602720
Number of Individuals Covered90
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $32,822
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $564,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,373
Insurance broker organization code?3
Insurance broker nameBCI INSURANCE
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number852099G
Policy instance 7
Insurance contract or identification number852099G
Number of Individuals Covered488
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,141
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,787
Insurance broker organization code?3
Insurance broker nameNEVINS FINANCIAL SERVICES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30011803
Policy instance 8
Insurance contract or identification number30011803
Number of Individuals Covered334
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,105
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,874
Insurance broker organization code?3
Insurance broker nameNEVINS FINANCIAL SERVICES
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberLABORER
Policy instance 9
Insurance contract or identification numberLABORER
Number of Individuals Covered29
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker name

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