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SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 401k Plan overview

Plan NameSOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND
Plan identification number 501

SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND Benefits

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

401k Sponsoring company profile

BOARD OF TRUSTEES, SOUTH BAY HOTEL EMPLOYEES RESTAURANT EE WELFARE FUN has sponsored the creation of one or more 401k plans.

Company Name:BOARD OF TRUSTEES, SOUTH BAY HOTEL EMPLOYEES RESTAURANT EE WELFARE FUN
Employer identification number (EIN):946080365
NAIC Classification:721110
NAIC Description:Hotels (except Casino Hotels) and Motels

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01ENRIQUE FERNANDEZ2023-10-12 JOHN SOUTHWELL2023-10-12
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01ENRIQUE FERNANDEZ DOUG CORNFORD2018-10-04
5012016-01-01ENRIQUE FERNANDEZ DOUG CORNFORD2017-10-10
5012015-01-01ENRIQUE FERNANDEZ DOUG CORNFORD2016-10-12
5012014-01-01ENRIQUE FERNANDEZ DOUG CORNFORD2015-10-07
5012013-01-01ENRIQUE FERNANDEZ DOUG CORNFORD2014-10-09
5012012-01-01ENRIQUE FERNANDEZ DOUG CORNFORD2013-10-01
5012011-01-01KENNETH C. PAULSEN DOUG CORNFORD2012-10-08
5012010-01-01KENNETH C. PAULSEN DOUG CORNFORD2011-09-29
5012009-01-01KENNETH C. PAULSEN DOUG CORNFORD2010-10-15

Plan Statistics for SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND

401k plan membership statisitcs for SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND

Measure Date Value
2022: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2022 401k membership
Total participants, beginning-of-year2022-01-011,845
Total number of active participants reported on line 7a of the Form 55002022-01-011,921
Number of retired or separated participants receiving benefits2022-01-015
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-011,926
Number of employers contributing to the scheme2022-01-0137
2021: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2021 401k membership
Total participants, beginning-of-year2021-01-013,596
Total number of active participants reported on line 7a of the Form 55002021-01-013,078
Number of retired or separated participants receiving benefits2021-01-013
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-013,081
Number of employers contributing to the scheme2021-01-0135
2020: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2020 401k membership
Total participants, beginning-of-year2020-01-014,117
Total number of active participants reported on line 7a of the Form 55002020-01-013,593
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-013,596
Number of employers contributing to the scheme2020-01-0136
2019: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2019 401k membership
Total participants, beginning-of-year2019-01-013,164
Total number of active participants reported on line 7a of the Form 55002019-01-014,109
Number of retired or separated participants receiving benefits2019-01-018
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-014,117
Number of employers contributing to the scheme2019-01-0136
2018: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2018 401k membership
Total participants, beginning-of-year2018-01-012,453
Total number of active participants reported on line 7a of the Form 55002018-01-013,157
Number of retired or separated participants receiving benefits2018-01-017
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-013,164
Number of employers contributing to the scheme2018-01-0135
2017: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2017 401k membership
Total participants, beginning-of-year2017-01-012,392
Total number of active participants reported on line 7a of the Form 55002017-01-012,447
Number of retired or separated participants receiving benefits2017-01-016
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-012,453
Number of employers contributing to the scheme2017-01-0132
2016: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2016 401k membership
Total participants, beginning-of-year2016-01-012,558
Total number of active participants reported on line 7a of the Form 55002016-01-012,385
Number of retired or separated participants receiving benefits2016-01-017
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-012,392
Number of employers contributing to the scheme2016-01-0133
2015: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2015 401k membership
Total participants, beginning-of-year2015-01-012,467
Total number of active participants reported on line 7a of the Form 55002015-01-012,551
Number of retired or separated participants receiving benefits2015-01-017
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-012,558
Number of employers contributing to the scheme2015-01-0134
2014: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2014 401k membership
Total participants, beginning-of-year2014-01-012,381
Total number of active participants reported on line 7a of the Form 55002014-01-012,457
Number of retired or separated participants receiving benefits2014-01-0110
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-012,467
Number of employers contributing to the scheme2014-01-0134
2013: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2013 401k membership
Total participants, beginning-of-year2013-01-012,248
Total number of active participants reported on line 7a of the Form 55002013-01-012,372
Number of retired or separated participants receiving benefits2013-01-019
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-012,381
Number of employers contributing to the scheme2013-01-0132
2012: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2012 401k membership
Total participants, beginning-of-year2012-01-012,333
Total number of active participants reported on line 7a of the Form 55002012-01-012,238
Number of retired or separated participants receiving benefits2012-01-0110
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-012,248
Number of employers contributing to the scheme2012-01-0133
2011: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2011 401k membership
Total participants, beginning-of-year2011-01-012,330
Total number of active participants reported on line 7a of the Form 55002011-01-012,322
Number of retired or separated participants receiving benefits2011-01-0111
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-012,333
Number of employers contributing to the scheme2011-01-0138
2010: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2010 401k membership
Total participants, beginning-of-year2010-01-012,291
Total number of active participants reported on line 7a of the Form 55002010-01-012,317
Number of retired or separated participants receiving benefits2010-01-0113
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-012,330
Number of employers contributing to the scheme2010-01-0140
2009: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2009 401k membership
Total participants, beginning-of-year2009-01-012,619
Total number of active participants reported on line 7a of the Form 55002009-01-012,276
Number of retired or separated participants receiving benefits2009-01-0115
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-012,291
Number of employers contributing to the scheme2009-01-0144

Financial Data on SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND

Measure Date Value
2022 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-756,810
Total unrealized appreciation/depreciation of assets2022-12-31$-756,810
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$1,222,298
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$2,102,094
Total income from all sources (including contributions)2022-12-31$24,718,504
Total loss/gain on sale of assets2022-12-31$-59,557
Total of all expenses incurred2022-12-31$25,251,415
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$24,301,147
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$27,606,739
Value of total assets at end of year2022-12-31$45,665,439
Value of total assets at beginning of year2022-12-31$47,078,146
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$950,268
Total interest from all sources2022-12-31$455,715
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$869,866
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$869,866
Administrative expenses professional fees incurred2022-12-31$185,770
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$430,678
Participant contributions at end of year2022-12-31$44,158
Participant contributions at beginning of year2022-12-31$37,645
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$4,752,313
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$3,970,434
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$12,059
Other income not declared elsewhere2022-12-31$1,481,997
Administrative expenses (other) incurred2022-12-31$99,316
Liabilities. Value of operating payables at end of year2022-12-31$49,239
Liabilities. Value of operating payables at beginning of year2022-12-31$70,094
Total non interest bearing cash at end of year2022-12-31$7,717,339
Total non interest bearing cash at beginning of year2022-12-31$5,868,454
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-532,911
Value of net assets at end of year (total assets less liabilities)2022-12-31$44,443,141
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$44,976,052
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$120,099
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$20,916,217
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$26,097,361
Interest earned on other investments2022-12-31$202,999
Income. Interest from US Government securities2022-12-31$106,412
Income. Interest from corporate debt instruments2022-12-31$145,653
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$292,097
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$546,154
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$546,154
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$651
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$16,760,664
Asset value of US Government securities at end of year2022-12-31$4,743,159
Asset value of US Government securities at beginning of year2022-12-31$4,373,795
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-4,879,446
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
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$27,176,061
Employer contributions (assets) at end of year2022-12-31$2,511,001
Employer contributions (assets) at beginning of year2022-12-31$2,182,499
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$7,540,483
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$4,689,155
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$4,001,804
Contract administrator fees2022-12-31$545,083
Liabilities. Value of benefit claims payable at end of year2022-12-31$1,161,000
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$2,032,000
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
Aggregate proceeds on sale of assets2022-12-31$4,370,540
Aggregate carrying amount (costs) on sale of assets2022-12-31$4,430,097
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31WITHUMSMITH+BROWN, PC
Accountancy firm EIN2022-12-31222027092
2021 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$-700,817
Total unrealized appreciation/depreciation of assets2021-12-31$-700,817
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$2,102,094
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$1,887,107
Total income from all sources (including contributions)2021-12-31$31,042,199
Total loss/gain on sale of assets2021-12-31$262,015
Total of all expenses incurred2021-12-31$25,744,689
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$24,673,903
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$25,153,590
Value of total assets at end of year2021-12-31$47,078,146
Value of total assets at beginning of year2021-12-31$41,565,649
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,070,786
Total interest from all sources2021-12-31$268,375
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$1,219,969
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$1,219,969
Administrative expenses professional fees incurred2021-12-31$148,786
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$394,967
Participant contributions at end of year2021-12-31$37,645
Participant contributions at beginning of year2021-12-31$18,055
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$3,970,434
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$388,368
Other income not declared elsewhere2021-12-31$4,316,265
Administrative expenses (other) incurred2021-12-31$140,949
Liabilities. Value of operating payables at end of year2021-12-31$70,094
Liabilities. Value of operating payables at beginning of year2021-12-31$53,107
Total non interest bearing cash at end of year2021-12-31$5,868,454
Total non interest bearing cash at beginning of year2021-12-31$2,866,502
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$5,297,510
Value of net assets at end of year (total assets less liabilities)2021-12-31$44,976,052
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$39,678,542
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$70,313
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$26,097,361
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$24,327,514
Income. Interest from US Government securities2021-12-31$113,817
Income. Interest from corporate debt instruments2021-12-31$154,498
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$546,154
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$395,356
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$395,356
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$60
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$17,121,342
Asset value of US Government securities at end of year2021-12-31$4,373,795
Asset value of US Government securities at beginning of year2021-12-31$5,512,719
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$522,802
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
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$24,758,623
Employer contributions (assets) at end of year2021-12-31$2,182,499
Employer contributions (assets) at beginning of year2021-12-31$1,859,320
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$7,552,561
Asset. Corporate debt instrument preferred debt at end of year2021-12-31$4,001,804
Asset. Corporate debt instrument preferred debt at beginning of year2021-12-31$5,022,104
Contract administrator fees2021-12-31$710,738
Assets. Corporate common stocks other than exployer securities at beginning of year2021-12-31$1,175,711
Liabilities. Value of benefit claims payable at end of year2021-12-31$2,032,000
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$1,834,000
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
Aggregate proceeds on sale of assets2021-12-31$3,881,999
Aggregate carrying amount (costs) on sale of assets2021-12-31$3,619,984
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WITHUMSMITH+BROWN, PC
Accountancy firm EIN2021-12-31222027092
2020 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$402,852
Total unrealized appreciation/depreciation of assets2020-12-31$402,852
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$1,887,107
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,299,316
Total income from all sources (including contributions)2020-12-31$29,498,650
Total loss/gain on sale of assets2020-12-31$88,414
Total of all expenses incurred2020-12-31$36,804,654
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$35,507,335
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$25,219,381
Value of total assets at end of year2020-12-31$41,565,649
Value of total assets at beginning of year2020-12-31$49,283,862
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,297,319
Total interest from all sources2020-12-31$323,767
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$606,364
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$579,060
Administrative expenses professional fees incurred2020-12-31$198,872
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$348,481
Participant contributions at end of year2020-12-31$18,055
Participant contributions at beginning of year2020-12-31$60,387
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$388,368
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$556,156
Other income not declared elsewhere2020-12-31$761,565
Administrative expenses (other) incurred2020-12-31$179,930
Liabilities. Value of operating payables at end of year2020-12-31$53,107
Liabilities. Value of operating payables at beginning of year2020-12-31$70,316
Total non interest bearing cash at end of year2020-12-31$2,866,502
Total non interest bearing cash at beginning of year2020-12-31$11,211,386
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-7,306,004
Value of net assets at end of year (total assets less liabilities)2020-12-31$39,678,542
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$46,984,546
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
Investment advisory and management fees2020-12-31$83,891
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$24,327,514
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$22,272,411
Income. Interest from US Government securities2020-12-31$139,801
Income. Interest from corporate debt instruments2020-12-31$183,512
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$395,356
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$545,862
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$545,862
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$454
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$28,014,142
Asset value of US Government securities at end of year2020-12-31$5,512,719
Asset value of US Government securities at beginning of year2020-12-31$5,261,207
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$2,096,307
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
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$24,870,900
Employer contributions (assets) at end of year2020-12-31$1,859,320
Employer contributions (assets) at beginning of year2020-12-31$3,542,672
Income. Dividends from common stock2020-12-31$27,304
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$7,493,193
Asset. Corporate debt instrument preferred debt at end of year2020-12-31$5,022,104
Asset. Corporate debt instrument preferred debt at beginning of year2020-12-31$4,677,681
Contract administrator fees2020-12-31$834,626
Assets. Corporate common stocks other than exployer securities at end of year2020-12-31$1,175,711
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$1,156,100
Liabilities. Value of benefit claims payable at end of year2020-12-31$1,834,000
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$2,229,000
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
Aggregate proceeds on sale of assets2020-12-31$5,128,508
Aggregate carrying amount (costs) on sale of assets2020-12-31$5,040,094
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31LINDQUIST LLP
Accountancy firm EIN2020-12-31522385296
2019 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$322,951
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$322,951
Total unrealized appreciation/depreciation of assets2019-12-31$322,951
Total unrealized appreciation/depreciation of assets2019-12-31$322,951
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,299,316
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,299,316
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,571,447
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,571,447
Total income from all sources (including contributions)2019-12-31$40,413,726
Total income from all sources (including contributions)2019-12-31$40,413,726
Total loss/gain on sale of assets2019-12-31$215,971
Total loss/gain on sale of assets2019-12-31$215,971
Total of all expenses incurred2019-12-31$32,180,138
Total of all expenses incurred2019-12-31$32,180,138
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$30,935,498
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$30,935,498
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$36,316,528
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$36,316,528
Value of total assets at end of year2019-12-31$49,283,862
Value of total assets at end of year2019-12-31$49,283,862
Value of total assets at beginning of year2019-12-31$40,322,405
Value of total assets at beginning of year2019-12-31$40,322,405
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,244,640
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,244,640
Total interest from all sources2019-12-31$252,024
Total interest from all sources2019-12-31$252,024
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$811,861
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$811,861
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$652,661
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$652,661
Administrative expenses professional fees incurred2019-12-31$201,623
Administrative expenses professional fees incurred2019-12-31$201,623
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$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
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$713,010
Contributions received from participants2019-12-31$713,010
Participant contributions at end of year2019-12-31$60,387
Participant contributions at end of year2019-12-31$60,387
Participant contributions at beginning of year2019-12-31$56,176
Participant contributions at beginning of year2019-12-31$56,176
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$556,156
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$556,156
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$707,497
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$707,497
Other income not declared elsewhere2019-12-31$571,974
Other income not declared elsewhere2019-12-31$571,974
Administrative expenses (other) incurred2019-12-31$192,147
Administrative expenses (other) incurred2019-12-31$192,147
Liabilities. Value of operating payables at end of year2019-12-31$70,316
Liabilities. Value of operating payables at end of year2019-12-31$70,316
Liabilities. Value of operating payables at beginning of year2019-12-31$74,447
Liabilities. Value of operating payables at beginning of year2019-12-31$74,447
Total non interest bearing cash at end of year2019-12-31$11,211,386
Total non interest bearing cash at end of year2019-12-31$11,211,386
Total non interest bearing cash at beginning of year2019-12-31$8,144,724
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$8,233,588
Value of net income/loss2019-12-31$8,233,588
Value of net assets at end of year (total assets less liabilities)2019-12-31$46,984,546
Value of net assets at end of year (total assets less liabilities)2019-12-31$46,984,546
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$38,750,958
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$38,750,958
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
Investment advisory and management fees2019-12-31$74,995
Investment advisory and management fees2019-12-31$74,995
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$22,272,411
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$22,272,411
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$18,160,664
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$18,160,664
Income. Interest from US Government securities2019-12-31$111,313
Income. Interest from US Government securities2019-12-31$111,313
Income. Interest from corporate debt instruments2019-12-31$136,931
Income. Interest from corporate debt instruments2019-12-31$136,931
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$545,862
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$545,862
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$507,272
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$507,272
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$507,272
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$507,272
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$3,780
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$3,780
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$25,414,605
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$25,414,605
Asset value of US Government securities at end of year2019-12-31$5,261,207
Asset value of US Government securities at end of year2019-12-31$5,261,207
Asset value of US Government securities at beginning of year2019-12-31$4,603,680
Asset value of US Government securities at beginning of year2019-12-31$4,603,680
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,922,417
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,922,417
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
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$35,603,518
Contributions received in cash from employer2019-12-31$35,603,518
Employer contributions (assets) at end of year2019-12-31$3,542,672
Employer contributions (assets) at end of year2019-12-31$3,542,672
Employer contributions (assets) at beginning of year2019-12-31$3,021,106
Employer contributions (assets) at beginning of year2019-12-31$3,021,106
Income. Dividends from common stock2019-12-31$159,200
Income. Dividends from common stock2019-12-31$159,200
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$5,520,893
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$5,520,893
Asset. Corporate debt instrument preferred debt at end of year2019-12-31$4,677,681
Asset. Corporate debt instrument preferred debt at end of year2019-12-31$4,677,681
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$3,882,680
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$3,882,680
Contract administrator fees2019-12-31$775,875
Contract administrator fees2019-12-31$775,875
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$1,156,100
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$1,156,100
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$1,238,606
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$1,238,606
Liabilities. Value of benefit claims payable at end of year2019-12-31$2,229,000
Liabilities. Value of benefit claims payable at end of year2019-12-31$2,229,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,497,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,497,000
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
Aggregate proceeds on sale of assets2019-12-31$3,893,493
Aggregate proceeds on sale of assets2019-12-31$3,893,493
Aggregate carrying amount (costs) on sale of assets2019-12-31$3,677,522
Aggregate carrying amount (costs) on sale of assets2019-12-31$3,677,522
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31LINDQUIST LLP
Accountancy firm name2019-12-31LINDQUIST LLP
Accountancy firm EIN2019-12-31522385296
2018 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-3,413,847
Total unrealized appreciation/depreciation of assets2018-12-31$-3,413,847
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$1,571,447
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$748,213
Total income from all sources (including contributions)2018-12-31$36,326,988
Total loss/gain on sale of assets2018-12-31$1,045,525
Total of all expenses incurred2018-12-31$28,186,065
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$27,068,784
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$34,752,521
Value of total assets at end of year2018-12-31$40,322,405
Value of total assets at beginning of year2018-12-31$31,358,248
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,117,281
Total interest from all sources2018-12-31$128,973
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$665,043
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$587,901
Administrative expenses professional fees incurred2018-12-31$145,965
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$652,847
Participant contributions at end of year2018-12-31$56,176
Participant contributions at beginning of year2018-12-31$56,816
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$707,497
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$217,278
Other income not declared elsewhere2018-12-31$1,964,612
Administrative expenses (other) incurred2018-12-31$170,792
Liabilities. Value of operating payables at end of year2018-12-31$74,447
Liabilities. Value of operating payables at beginning of year2018-12-31$41,313
Total non interest bearing cash at end of year2018-12-31$8,144,724
Total non interest bearing cash at beginning of year2018-12-31$9,628,128
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$8,140,923
Value of net assets at end of year (total assets less liabilities)2018-12-31$38,750,958
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$30,610,035
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$83,171
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$18,160,664
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$17,694,009
Income. Interest from US Government securities2018-12-31$62,778
Income. Interest from corporate debt instruments2018-12-31$60,263
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$507,272
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$5,932
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$21,210,708
Asset value of US Government securities at end of year2018-12-31$4,603,680
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$1,184,161
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
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$34,099,674
Employer contributions (assets) at end of year2018-12-31$3,021,106
Employer contributions (assets) at beginning of year2018-12-31$3,762,017
Income. Dividends from common stock2018-12-31$77,142
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$5,858,076
Asset. Corporate debt instrument preferred debt at end of year2018-12-31$3,882,680
Contract administrator fees2018-12-31$717,353
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$1,238,606
Liabilities. Value of benefit claims payable at end of year2018-12-31$1,497,000
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$706,900
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
Aggregate proceeds on sale of assets2018-12-31$4,856,433
Aggregate carrying amount (costs) on sale of assets2018-12-31$3,810,908
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 name2018-12-31LINDQUIST LLP
Accountancy firm EIN2018-12-31522385296
2017 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$748,213
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$662,774
Total income from all sources (including contributions)2017-12-31$32,257,486
Total of all expenses incurred2017-12-31$24,415,832
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$23,515,138
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$30,890,239
Value of total assets at end of year2017-12-31$31,358,248
Value of total assets at beginning of year2017-12-31$23,431,155
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$900,694
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$312,783
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$312,783
Administrative expenses professional fees incurred2017-12-31$185,337
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$707,553
Participant contributions at end of year2017-12-31$56,816
Participant contributions at beginning of year2017-12-31$60,316
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$217,278
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$88,912
Other income not declared elsewhere2017-12-31$294,835
Administrative expenses (other) incurred2017-12-31$153,146
Liabilities. Value of operating payables at end of year2017-12-31$41,313
Liabilities. Value of operating payables at beginning of year2017-12-31$55,774
Total non interest bearing cash at end of year2017-12-31$9,628,128
Total non interest bearing cash at beginning of year2017-12-31$9,874,650
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$7,841,654
Value of net assets at end of year (total assets less liabilities)2017-12-31$30,610,035
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$22,768,381
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
Investment advisory and management fees2017-12-31$15,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$17,694,009
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$10,621,595
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$20,061,915
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$759,629
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
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$30,182,686
Employer contributions (assets) at end of year2017-12-31$3,762,017
Employer contributions (assets) at beginning of year2017-12-31$2,785,682
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$3,453,223
Contract administrator fees2017-12-31$547,211
Liabilities. Value of benefit claims payable at end of year2017-12-31$706,900
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$607,000
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 name2017-12-31LINDQUIST LLP
Accountancy firm EIN2017-12-31522385296
2016 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$662,774
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,049,109
Total income from all sources (including contributions)2016-12-31$30,160,867
Total of all expenses incurred2016-12-31$25,205,174
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$24,429,012
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$29,311,497
Value of total assets at end of year2016-12-31$23,431,155
Value of total assets at beginning of year2016-12-31$18,861,797
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$776,162
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$208,721
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$208,721
Administrative expenses professional fees incurred2016-12-31$149,922
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$5,000,000
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$755,636
Participant contributions at end of year2016-12-31$60,316
Participant contributions at beginning of year2016-12-31$54,744
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$88,912
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$523,215
Other income not declared elsewhere2016-12-31$323,132
Administrative expenses (other) incurred2016-12-31$142,891
Liabilities. Value of operating payables at end of year2016-12-31$55,774
Liabilities. Value of operating payables at beginning of year2016-12-31$49,109
Total non interest bearing cash at end of year2016-12-31$9,874,650
Total non interest bearing cash at beginning of year2016-12-31$5,830,186
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$4,955,693
Value of net assets at end of year (total assets less liabilities)2016-12-31$22,768,381
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$17,812,688
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$10,621,595
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$10,095,358
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$20,812,252
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$317,517
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$28,555,861
Employer contributions (assets) at end of year2016-12-31$2,785,682
Employer contributions (assets) at beginning of year2016-12-31$2,358,294
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$3,616,760
Contract administrator fees2016-12-31$483,349
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$607,000
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$1,000,000
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 name2016-12-31LINDQUIST LLP
Accountancy firm EIN2016-12-31522385296
2015 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$1,049,109
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$998,071
Total income from all sources (including contributions)2015-12-31$28,694,968
Total of all expenses incurred2015-12-31$26,210,215
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$25,518,458
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$27,867,115
Value of total assets at end of year2015-12-31$18,861,797
Value of total assets at beginning of year2015-12-31$16,326,006
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$691,757
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$155,033
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$155,033
Administrative expenses professional fees incurred2015-12-31$119,282
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$5,000,000
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$737,319
Participant contributions at end of year2015-12-31$54,744
Participant contributions at beginning of year2015-12-31$63,668
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$523,215
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$31,233
Other income not declared elsewhere2015-12-31$795,454
Administrative expenses (other) incurred2015-12-31$127,423
Liabilities. Value of operating payables at end of year2015-12-31$49,109
Liabilities. Value of operating payables at beginning of year2015-12-31$84,071
Total non interest bearing cash at end of year2015-12-31$5,830,186
Total non interest bearing cash at beginning of year2015-12-31$9,937,148
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$2,484,753
Value of net assets at end of year (total assets less liabilities)2015-12-31$17,812,688
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$15,327,935
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$10,095,358
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$4,062,959
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$21,031,101
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-122,634
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
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$27,129,796
Employer contributions (assets) at end of year2015-12-31$2,358,294
Employer contributions (assets) at beginning of year2015-12-31$2,230,998
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$4,487,357
Contract administrator fees2015-12-31$445,052
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$1,000,000
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$914,000
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 name2015-12-31LINDQUIST LLP
Accountancy firm EIN2015-12-31522385296
2014 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$998,071
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$663,856
Total income from all sources (including contributions)2014-12-31$26,192,388
Total of all expenses incurred2014-12-31$23,024,749
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$22,313,557
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$25,862,358
Value of total assets at end of year2014-12-31$16,326,006
Value of total assets at beginning of year2014-12-31$12,824,152
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$711,192
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$76,519
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$76,519
Administrative expenses professional fees incurred2014-12-31$120,725
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$5,000,000
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$781,373
Participant contributions at end of year2014-12-31$63,668
Participant contributions at beginning of year2014-12-31$63,940
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$31,233
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$199,577
Other income not declared elsewhere2014-12-31$93,495
Administrative expenses (other) incurred2014-12-31$145,379
Liabilities. Value of operating payables at end of year2014-12-31$84,071
Liabilities. Value of operating payables at beginning of year2014-12-31$25,856
Total non interest bearing cash at end of year2014-12-31$9,937,148
Total non interest bearing cash at beginning of year2014-12-31$6,821,364
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$3,167,639
Value of net assets at end of year (total assets less liabilities)2014-12-31$15,327,935
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$12,160,296
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
Investment advisory and management fees2014-12-31$15,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$4,062,959
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$3,826,425
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$19,419,391
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$160,016
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$25,080,985
Employer contributions (assets) at end of year2014-12-31$2,230,998
Employer contributions (assets) at beginning of year2014-12-31$1,912,846
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$2,894,166
Contract administrator fees2014-12-31$430,088
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$914,000
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$638,000
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 name2014-12-31LINDQUIST LLP
Accountancy firm EIN2014-12-31522385296
2013 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$663,856
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$297,053
Total income from all sources (including contributions)2013-12-31$25,015,140
Total of all expenses incurred2013-12-31$20,545,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$19,908,807
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$24,528,071
Value of total assets at end of year2013-12-31$12,824,152
Value of total assets at beginning of year2013-12-31$7,987,676
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$636,660
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$73,771
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$73,771
Administrative expenses professional fees incurred2013-12-31$126,349
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$5,000,000
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$804,377
Participant contributions at end of year2013-12-31$63,940
Participant contributions at beginning of year2013-12-31$61,539
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$199,577
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$121,823
Other income not declared elsewhere2013-12-31$230,394
Administrative expenses (other) incurred2013-12-31$79,182
Liabilities. Value of operating payables at end of year2013-12-31$25,856
Liabilities. Value of operating payables at beginning of year2013-12-31$57,053
Total non interest bearing cash at end of year2013-12-31$6,821,364
Total non interest bearing cash at beginning of year2013-12-31$39,336
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$4,469,673
Value of net assets at end of year (total assets less liabilities)2013-12-31$12,160,296
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$7,690,623
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 in registered invesment companies (eg mutual funds) at end of year2013-12-31$3,826,425
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$3,569,750
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$2,451,256
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$2,451,256
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$17,658,707
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$182,904
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$23,723,694
Employer contributions (assets) at end of year2013-12-31$1,912,846
Employer contributions (assets) at beginning of year2013-12-31$1,743,972
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$2,250,100
Contract administrator fees2013-12-31$431,129
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$638,000
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$240,000
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 name2013-12-31LINDQUIST LLP
Accountancy firm EIN2013-12-31522385296
2012 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$297,053
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$142,881
Total income from all sources (including contributions)2012-12-31$20,018,631
Total of all expenses incurred2012-12-31$19,674,915
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$19,147,616
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$19,777,067
Value of total assets at end of year2012-12-31$7,987,676
Value of total assets at beginning of year2012-12-31$7,489,788
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$527,299
Total interest from all sources2012-12-31$950
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$82,520
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$82,520
Administrative expenses professional fees incurred2012-12-31$107,899
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$5,000,000
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$692,798
Participant contributions at end of year2012-12-31$61,539
Participant contributions at beginning of year2012-12-31$44,380
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$121,823
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$20,789
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$22,212
Other income not declared elsewhere2012-12-31$47,253
Administrative expenses (other) incurred2012-12-31$90,260
Liabilities. Value of operating payables at end of year2012-12-31$57,053
Liabilities. Value of operating payables at beginning of year2012-12-31$36,669
Total non interest bearing cash at end of year2012-12-31$39,336
Total non interest bearing cash at beginning of year2012-12-31$7,821
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$343,716
Value of net assets at end of year (total assets less liabilities)2012-12-31$7,690,623
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$7,346,907
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 in registered invesment companies (eg mutual funds) at end of year2012-12-31$3,569,750
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$3,376,390
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$2,451,256
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$2,463,134
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$2,463,134
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$950
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$18,162,572
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$110,841
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$19,084,269
Employer contributions (assets) at end of year2012-12-31$1,743,972
Employer contributions (assets) at beginning of year2012-12-31$1,577,274
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$985,044
Contract administrator fees2012-12-31$329,140
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$240,000
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$84,000
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 name2012-12-31LINDQUIST LLP
Accountancy firm EIN2012-12-31522385296
2011 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$142,881
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$122,669
Total income from all sources (including contributions)2011-12-31$18,855,192
Total of all expenses incurred2011-12-31$17,927,960
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$17,442,597
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$18,693,521
Value of total assets at end of year2011-12-31$7,489,788
Value of total assets at beginning of year2011-12-31$6,542,344
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$485,363
Total interest from all sources2011-12-31$816
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$90,808
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$90,808
Administrative expenses professional fees incurred2011-12-31$125,480
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$5,000,000
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$637,304
Participant contributions at end of year2011-12-31$44,380
Participant contributions at beginning of year2011-12-31$46,823
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$20,789
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$316,911
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$22,212
Other income not declared elsewhere2011-12-31$24,802
Administrative expenses (other) incurred2011-12-31$87,815
Liabilities. Value of operating payables at end of year2011-12-31$36,669
Liabilities. Value of operating payables at beginning of year2011-12-31$44,669
Total non interest bearing cash at end of year2011-12-31$7,821
Total non interest bearing cash at beginning of year2011-12-31$30,470
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$927,232
Value of net assets at end of year (total assets less liabilities)2011-12-31$7,346,907
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$6,419,675
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 in registered invesment companies (eg mutual funds) at end of year2011-12-31$3,376,390
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$3,240,336
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$2,463,134
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$1,522,519
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$1,522,519
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$816
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$16,695,149
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$45,245
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$18,056,217
Employer contributions (assets) at end of year2011-12-31$1,577,274
Employer contributions (assets) at beginning of year2011-12-31$1,385,285
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$747,448
Contract administrator fees2011-12-31$272,068
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$84,000
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$78,000
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 name2011-12-31LINDQUIST LLP
Accountancy firm EIN2011-12-31522385296
2010 : SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$122,669
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$531,828
Total income from all sources (including contributions)2010-12-31$17,120,817
Total of all expenses incurred2010-12-31$16,881,996
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$16,369,644
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$16,423,413
Value of total assets at end of year2010-12-31$6,542,344
Value of total assets at beginning of year2010-12-31$6,712,682
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$512,352
Total interest from all sources2010-12-31$496
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$100,376
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$100,376
Administrative expenses professional fees incurred2010-12-31$154,815
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$5,000,000
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$613,007
Participant contributions at end of year2010-12-31$46,823
Participant contributions at beginning of year2010-12-31$41,338
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$316,911
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$25,195
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$36,221
Other income not declared elsewhere2010-12-31$455,699
Administrative expenses (other) incurred2010-12-31$94,893
Liabilities. Value of operating payables at end of year2010-12-31$44,669
Liabilities. Value of operating payables at beginning of year2010-12-31$30,607
Total non interest bearing cash at end of year2010-12-31$30,470
Total non interest bearing cash at beginning of year2010-12-31$2,000
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$238,821
Value of net assets at end of year (total assets less liabilities)2010-12-31$6,419,675
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$6,180,854
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 in registered invesment companies (eg mutual funds) at end of year2010-12-31$3,240,336
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$4,449,128
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$1,522,519
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$962,713
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$962,713
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$496
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$15,038,192
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$140,833
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
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$15,810,406
Employer contributions (assets) at end of year2010-12-31$1,385,285
Employer contributions (assets) at beginning of year2010-12-31$1,232,308
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,331,452
Contract administrator fees2010-12-31$262,644
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$78,000
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$465,000
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 name2010-12-31LINDQUIST LLP
Accountancy firm EIN2010-12-31522385296

Form 5500 Responses for SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND

2022: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2022 form 5500 responses
2022-01-01Type of plan entityMulti-employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2021 form 5500 responses
2021-01-01Type of plan entityMulti-employer plan
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2020 form 5500 responses
2020-01-01Type of plan entityMulti-employer plan
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2018 form 5500 responses
2018-01-01Type of plan entityMulti-employer plan
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2013 form 5500 responses
2013-01-01Type of plan entityMulti-employer plan
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2010 form 5500 responses
2010-01-01Type of plan entityMulti-employer plan
2010-01-01Plan is a collectively bargained planYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: SOUTH BAY HOTEL EMPLOYEES RESTAURANT EMPLOYEES WELFARE FUND 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number805715G
Policy instance 2
Insurance contract or identification number805715G
Number of Individuals Covered3072
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 providedAD&D
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 $99,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract number11811937
Policy instance 1
Insurance contract or identification number11811937
Number of Individuals Covered729
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
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 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 $839,651
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 number8186
Policy instance 3
Insurance contract or identification number8186
Number of Individuals Covered2124
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 $14,983,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0151059
Policy instance 4
Insurance contract or identification number0151059
Number of Individuals Covered2320
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
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 $1,595,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number0151059
Policy instance 5
Insurance contract or identification number0151059
Number of Individuals Covered664
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
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 $83,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberSL10225
Policy instance 6
Insurance contract or identification numberSL10225
Number of Individuals Covered1178
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $16,041
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 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 $802,034
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,041
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number00105895
Policy instance 7
Insurance contract or identification number00105895
Number of Individuals Covered1937
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
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
Welfare Benefit Premiums Paid to CarrierUSD $138,608
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered1868
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
Welfare Benefit Premiums Paid to CarrierUSD $15,298,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number0151059
Policy instance 4
Insurance contract or identification number0151059
Number of Individuals Covered752
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0151059
Policy instance 3
Insurance contract or identification number0151059
Number of Individuals Covered2031
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,407,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract number1181920
Policy instance 5
Insurance contract or identification number1181920
Number of Individuals Covered758
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
Welfare Benefit Premiums Paid to CarrierUSD $847,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number805715G
Policy instance 6
Insurance contract or identification number805715G
Number of Individuals Covered4704
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 providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $99,383
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered1709
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
Welfare Benefit Premiums Paid to CarrierUSD $141,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number0151059
Policy instance 5
Insurance contract or identification number0151059
Number of Individuals Covered1504
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 $193,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract number1181863
Policy instance 6
Insurance contract or identification number1181863
Number of Individuals Covered1219
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
Welfare Benefit Premiums Paid to CarrierUSD $1,104,712
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered3032
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
Welfare Benefit Premiums Paid to CarrierUSD $154,025
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered3516
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
Welfare Benefit Premiums Paid to CarrierUSD $25,964,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0151059
Policy instance 4
Insurance contract or identification number0151059
Number of Individuals Covered3643
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 $2,360,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number70815
Policy instance 7
Insurance contract or identification number70815
Number of Individuals Covered6979
Insurance policy start date2020-08-01
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 providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $60,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0476663
Policy instance 3
Insurance contract or identification number0476663
Number of Individuals Covered3950
Insurance policy start date2020-01-01
Insurance policy end date2020-07-31
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 & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $101,052
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered2600
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
Welfare Benefit Premiums Paid to CarrierUSD $221,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS1181680
Policy instance 3
Insurance contract or identification numberUS1181680
Number of Individuals Covered1257
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
Welfare Benefit Premiums Paid to CarrierUSD $937,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0476663
Policy instance 4
Insurance contract or identification number0476663
Number of Individuals Covered3673
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 & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $158,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0151059
Policy instance 5
Insurance contract or identification number0151059
Number of Individuals Covered4784
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 $2,197,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number0151059
Policy instance 6
Insurance contract or identification number0151059
Number of Individuals Covered2147
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 $184,479
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered3276
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
Welfare Benefit Premiums Paid to CarrierUSD $20,115,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0151059
Policy instance 5
Insurance contract or identification number0151059
Number of Individuals Covered2723
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 $2,054,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0476663
Policy instance 4
Insurance contract or identification number0476663
Number of Individuals Covered3207
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 & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $144,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31706
Policy instance 3
Insurance contract or identification numberHCL31706
Number of Individuals Covered940
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
Welfare Benefit Premiums Paid to CarrierUSD $758,140
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered2283
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
Welfare Benefit Premiums Paid to CarrierUSD $196,669
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered3058
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
Welfare Benefit Premiums Paid to CarrierUSD $16,510,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number0151059
Policy instance 6
Insurance contract or identification number0151059
Number of Individuals Covered1215
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 $163,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0151059
Policy instance 5
Insurance contract or identification number0151059
Number of Individuals Covered2624
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,841,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0476663
Policy instance 4
Insurance contract or identification number0476663
Number of Individuals Covered3015
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
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $125,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31706
Policy instance 3
Insurance contract or identification numberHCL31706
Number of Individuals Covered701
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
Welfare Benefit Premiums Paid to CarrierUSD $590,591
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered2142
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $177,094
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered2967
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
Welfare Benefit Premiums Paid to CarrierUSD $16,887,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number0151059
Policy instance 6
Insurance contract or identification number0151059
Number of Individuals Covered1195
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $160,603
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered2154
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $151,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0151059
Policy instance 5
Insurance contract or identification number0151059
Number of Individuals Covered2506
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 $1,804,210
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered3003
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $18,194,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476663
Policy instance 4
Insurance contract or identification number476663
Number of Individuals Covered2969
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $129,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number0151059
Policy instance 6
Insurance contract or identification number0151059
Number of Individuals Covered1356
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 $179,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31706
Policy instance 3
Insurance contract or identification numberHCL31706
Number of Individuals Covered732
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $570,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number0151059
Policy instance 6
Insurance contract or identification number0151059
Number of Individuals Covered1352
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $180,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number655382
Policy instance 3
Insurance contract or identification number655382
Number of Individuals Covered732
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
Welfare Benefit Premiums Paid to CarrierUSD $543,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0151059
Policy instance 5
Insurance contract or identification number0151059
Number of Individuals Covered2444
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,513,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476663
Policy instance 4
Insurance contract or identification number476663
Number of Individuals Covered2891
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
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $123,630
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered2060
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $144,897
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered2951
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
Welfare Benefit Premiums Paid to CarrierUSD $16,929,938
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered1981
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $127,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number0151059
Policy instance 7
Insurance contract or identification number0151059
Number of Individuals Covered1384
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $176,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number655832
Policy instance 4
Insurance contract or identification number655832
Number of Individuals Covered683
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
Welfare Benefit Premiums Paid to CarrierUSD $504,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0151059
Policy instance 6
Insurance contract or identification number0151059
Number of Individuals Covered2197
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,148,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476663
Policy instance 5
Insurance contract or identification number476663
Number of Individuals Covered2748
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
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $120,081
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 number147860
Policy instance 3
Insurance contract or identification number147860
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 $31,783
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered2813
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 $15,543,796
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered2867
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 $15,994,063
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered1919
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number05439
Policy instance 7
Insurance contract or identification number05439
Number of Individuals Covered2226
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $737,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number06367
Policy instance 6
Insurance contract or identification number06367
Number of Individuals Covered886
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $265,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476663
Policy instance 5
Insurance contract or identification number476663
Number of Individuals Covered2709
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
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $115,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number655832
Policy instance 4
Insurance contract or identification number655832
Number of Individuals Covered585
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
Welfare Benefit Premiums Paid to CarrierUSD $333,223
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 number147860
Policy instance 3
Insurance contract or identification number147860
Number of Individuals Covered9
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 $619,846
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476663
Policy instance 6
Insurance contract or identification number476663
Number of Individuals Covered2694
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
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $92,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5439
Policy instance 8
Insurance contract or identification number5439
Number of Individuals Covered888
Insurance policy start date2011-06-01
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $366,582
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 number8186
Policy instance 1
Insurance contract or identification number8186
Number of Individuals Covered3028
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 $14,267,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number06367
Policy instance 7
Insurance contract or identification number06367
Number of Individuals Covered1073
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $315,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number655832
Policy instance 5
Insurance contract or identification number655832
Number of Individuals Covered404
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
Welfare Benefit Premiums Paid to CarrierUSD $262,292
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 number64473A
Policy instance 4
Insurance contract or identification number64473A
Number of Individuals Covered0
Insurance policy start date2011-01-01
Insurance policy end date2011-08-31
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 $285,514
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 number147860
Policy instance 3
Insurance contract or identification number147860
Number of Individuals Covered86
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 $896,865
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 number00105895
Policy instance 2
Insurance contract or identification number00105895
Number of Individuals Covered1939
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number0655832
Policy instance 6
Insurance contract or identification number0655832
Number of Individuals Covered422
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
Welfare Benefit Premiums Paid to CarrierUSD $206,190
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 number00105895
Policy instance 3
Insurance contract or identification number00105895
Number of Individuals Covered1962
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $139,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number06367-9001
Policy instance 10
Insurance contract or identification number06367-9001
Number of Individuals Covered1
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0367-0001
Policy instance 9
Insurance contract or identification number0367-0001
Number of Individuals Covered1853
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $464,627
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 number8186-0002
Policy instance 8
Insurance contract or identification number8186-0002
Number of Individuals Covered138
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 $486,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476663
Policy instance 7
Insurance contract or identification number476663
Number of Individuals Covered2652
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
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $73,182
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 number64473A
Policy instance 5
Insurance contract or identification number64473A
Number of Individuals Covered46
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 $366,436
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 number147860
Policy instance 4
Insurance contract or identification number147860
Number of Individuals Covered86
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 $831,046
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 number8186-0000
Policy instance 1
Insurance contract or identification number8186-0000
Number of Individuals Covered2612
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 $12,402,651
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 number8186-0001
Policy instance 2
Insurance contract or identification number8186-0001
Number of Individuals Covered10
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 $35,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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