SHOP IRONWORKERS LOCAL 790 WELFARE has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SHOP IRONWORKERS LOCAL 790 WELFARE
| Measure | Date | Value |
|---|
| 2023 : SHOP IRONWORKERS LOCAL 790 WELFARE 2023 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-06-30 | $3,168,809 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-06-30 | $3,492,987 |
| Total income from all sources (including contributions) | 2023-06-30 | $10,385,823 |
| Total loss/gain on sale of assets | 2023-06-30 | $157 |
| Total of all expenses incurred | 2023-06-30 | $10,305,365 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-06-30 | $9,942,172 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-06-30 | $10,154,329 |
| Value of total assets at end of year | 2023-06-30 | $8,829,355 |
| Value of total assets at beginning of year | 2023-06-30 | $9,073,075 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-06-30 | $363,193 |
| Total interest from all sources | 2023-06-30 | $129,747 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-06-30 | $142,937 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2023-06-30 | $142,937 |
| Administrative expenses professional fees incurred | 2023-06-30 | $125,252 |
| Was this plan covered by a fidelity bond | 2023-06-30 | Yes |
| Value of fidelity bond cover | 2023-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2023-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2023-06-30 | No |
| Contributions received from participants | 2023-06-30 | $48,644 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-06-30 | $1,972,020 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-06-30 | $1,000,768 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-06-30 | $3,085,060 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-06-30 | $3,310,760 |
| Administrative expenses (other) incurred | 2023-06-30 | $32,503 |
| Liabilities. Value of operating payables at end of year | 2023-06-30 | $83,749 |
| Liabilities. Value of operating payables at beginning of year | 2023-06-30 | $182,227 |
| Total non interest bearing cash at end of year | 2023-06-30 | $3,287 |
| Total non interest bearing cash at beginning of year | 2023-06-30 | $1,574 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-06-30 | No |
| Value of net income/loss | 2023-06-30 | $80,458 |
| Value of net assets at end of year (total assets less liabilities) | 2023-06-30 | $5,660,546 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-06-30 | $5,580,088 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-06-30 | No |
| Investment advisory and management fees | 2023-06-30 | $16,372 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2023-06-30 | $3,478,066 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2023-06-30 | $3,376,480 |
| Value of interest in pooled separate accounts at end of year | 2023-06-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-06-30 | $2,877,614 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-06-30 | $4,135,115 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-06-30 | $4,135,115 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-06-30 | $129,747 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-06-30 | $1,310,616 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2023-06-30 | $-41,347 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-06-30 | No |
| Contributions received in cash from employer | 2023-06-30 | $10,105,685 |
| Employer contributions (assets) at end of year | 2023-06-30 | $498,368 |
| Employer contributions (assets) at beginning of year | 2023-06-30 | $559,138 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-06-30 | $8,631,556 |
| Contract administrator fees | 2023-06-30 | $189,066 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2023-06-30 | No |
| Did the plan have assets held for investment | 2023-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-06-30 | No |
| Aggregate proceeds on sale of assets | 2023-06-30 | $11,797,929 |
| Aggregate carrying amount (costs) on sale of assets | 2023-06-30 | $11,797,772 |
| Opinion of an independent qualified public accountant for this plan | 2023-06-30 | Unqualified |
| Accountancy firm name | 2023-06-30 | MCMENOMY & ASSOCIATES CPAS LLP |
| Accountancy firm EIN | 2023-06-30 | 461559312 |
| 2022 : SHOP IRONWORKERS LOCAL 790 WELFARE 2022 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $3,492,987 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $3,710,415 |
| Total income from all sources (including contributions) | 2022-06-30 | $9,306,285 |
| Total loss/gain on sale of assets | 2022-06-30 | $142,876 |
| Total of all expenses incurred | 2022-06-30 | $9,723,573 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-06-30 | $9,327,796 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-06-30 | $9,675,617 |
| Value of total assets at end of year | 2022-06-30 | $9,073,075 |
| Value of total assets at beginning of year | 2022-06-30 | $9,707,791 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-06-30 | $395,777 |
| Total interest from all sources | 2022-06-30 | $6,072 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-06-30 | $106,953 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-06-30 | $106,953 |
| Administrative expenses professional fees incurred | 2022-06-30 | $150,559 |
| Was this plan covered by a fidelity bond | 2022-06-30 | Yes |
| Value of fidelity bond cover | 2022-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2022-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-06-30 | No |
| Contributions received from participants | 2022-06-30 | $66,091 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-06-30 | $1,000,768 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-06-30 | $3,195,166 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-06-30 | $3,310,760 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-06-30 | $3,679,754 |
| Other income not declared elsewhere | 2022-06-30 | $4,773 |
| Administrative expenses (other) incurred | 2022-06-30 | $28,815 |
| Liabilities. Value of operating payables at end of year | 2022-06-30 | $182,227 |
| Liabilities. Value of operating payables at beginning of year | 2022-06-30 | $30,661 |
| Total non interest bearing cash at end of year | 2022-06-30 | $1,574 |
| Total non interest bearing cash at beginning of year | 2022-06-30 | $3,481 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Value of net income/loss | 2022-06-30 | $-417,288 |
| Value of net assets at end of year (total assets less liabilities) | 2022-06-30 | $5,580,088 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-06-30 | $5,997,376 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-06-30 | No |
| Investment advisory and management fees | 2022-06-30 | $16,492 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-06-30 | $3,376,480 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-06-30 | $6,006,672 |
| Value of interest in pooled separate accounts at end of year | 2022-06-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-06-30 | $4,135,115 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-06-30 | $19,776 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-06-30 | $19,776 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-06-30 | $6,072 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-06-30 | $1,375,551 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-06-30 | $-630,006 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-06-30 | No |
| Contributions received in cash from employer | 2022-06-30 | $9,609,526 |
| Employer contributions (assets) at end of year | 2022-06-30 | $559,138 |
| Employer contributions (assets) at beginning of year | 2022-06-30 | $482,696 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-06-30 | $7,952,245 |
| Contract administrator fees | 2022-06-30 | $199,911 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-06-30 | No |
| Did the plan have assets held for investment | 2022-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-06-30 | No |
| Aggregate proceeds on sale of assets | 2022-06-30 | $12,590,500 |
| Aggregate carrying amount (costs) on sale of assets | 2022-06-30 | $12,447,624 |
| Opinion of an independent qualified public accountant for this plan | 2022-06-30 | Unqualified |
| Accountancy firm name | 2022-06-30 | MCMENOMY & ASSOCIATES CPAS LLP |
| Accountancy firm EIN | 2022-06-30 | 461559312 |
| 2021 : SHOP IRONWORKERS LOCAL 790 WELFARE 2021 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $3,710,415 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $3,895,702 |
| Total income from all sources (including contributions) | 2021-06-30 | $10,255,615 |
| Total of all expenses incurred | 2021-06-30 | $11,352,507 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-06-30 | $10,954,569 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-06-30 | $9,668,351 |
| Value of total assets at end of year | 2021-06-30 | $9,707,791 |
| Value of total assets at beginning of year | 2021-06-30 | $10,989,970 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-06-30 | $397,938 |
| Total interest from all sources | 2021-06-30 | $232 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-06-30 | $220,929 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-06-30 | $220,929 |
| Administrative expenses professional fees incurred | 2021-06-30 | $112,371 |
| Was this plan covered by a fidelity bond | 2021-06-30 | Yes |
| Value of fidelity bond cover | 2021-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2021-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-06-30 | No |
| Contributions received from participants | 2021-06-30 | $135,800 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-06-30 | $3,195,166 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-06-30 | $360,053 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-06-30 | $3,679,754 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-06-30 | $3,565,636 |
| Other income not declared elsewhere | 2021-06-30 | $18,335 |
| Administrative expenses (other) incurred | 2021-06-30 | $35,363 |
| Liabilities. Value of operating payables at end of year | 2021-06-30 | $30,661 |
| Liabilities. Value of operating payables at beginning of year | 2021-06-30 | $330,066 |
| Total non interest bearing cash at end of year | 2021-06-30 | $3,481 |
| Total non interest bearing cash at beginning of year | 2021-06-30 | $23,997 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Value of net income/loss | 2021-06-30 | $-1,096,892 |
| Value of net assets at end of year (total assets less liabilities) | 2021-06-30 | $5,997,376 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-06-30 | $7,094,268 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-06-30 | No |
| Investment advisory and management fees | 2021-06-30 | $9,564 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-06-30 | $6,006,672 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-06-30 | $8,531,176 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-06-30 | $19,776 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-06-30 | $1,524,832 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-06-30 | $1,524,832 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-06-30 | $232 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-06-30 | $1,418,098 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-06-30 | $347,768 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-06-30 | No |
| Contributions received in cash from employer | 2021-06-30 | $9,532,551 |
| Employer contributions (assets) at end of year | 2021-06-30 | $482,696 |
| Employer contributions (assets) at beginning of year | 2021-06-30 | $549,912 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-06-30 | $9,536,471 |
| Contract administrator fees | 2021-06-30 | $240,640 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-06-30 | No |
| Did the plan have assets held for investment | 2021-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-06-30 | Unqualified |
| Accountancy firm name | 2021-06-30 | EIDE BAILLY LLP |
| Accountancy firm EIN | 2021-06-30 | 450250958 |
| 2020 : SHOP IRONWORKERS LOCAL 790 WELFARE 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-06-30 | $5,731 |
| Total unrealized appreciation/depreciation of assets | 2020-06-30 | $5,731 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $3,895,702 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $3,332,562 |
| Total income from all sources (including contributions) | 2020-06-30 | $11,449,024 |
| Total loss/gain on sale of assets | 2020-06-30 | $0 |
| Total of all expenses incurred | 2020-06-30 | $12,527,699 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-06-30 | $12,075,964 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-06-30 | $11,130,544 |
| Value of total assets at end of year | 2020-06-30 | $10,989,970 |
| Value of total assets at beginning of year | 2020-06-30 | $11,505,505 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-06-30 | $451,735 |
| Total interest from all sources | 2020-06-30 | $22,050 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-06-30 | $318,218 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-06-30 | $318,218 |
| Administrative expenses professional fees incurred | 2020-06-30 | $159,593 |
| Was this plan covered by a fidelity bond | 2020-06-30 | Yes |
| Value of fidelity bond cover | 2020-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-06-30 | No |
| Contributions received from participants | 2020-06-30 | $91,764 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-06-30 | $360,053 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-06-30 | $714,167 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-06-30 | $3,565,636 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-06-30 | $3,085,186 |
| Other income not declared elsewhere | 2020-06-30 | $2,510 |
| Administrative expenses (other) incurred | 2020-06-30 | $36,330 |
| Liabilities. Value of operating payables at end of year | 2020-06-30 | $330,066 |
| Liabilities. Value of operating payables at beginning of year | 2020-06-30 | $247,376 |
| Total non interest bearing cash at end of year | 2020-06-30 | $23,997 |
| Total non interest bearing cash at beginning of year | 2020-06-30 | $26,583 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Value of net income/loss | 2020-06-30 | $-1,078,675 |
| Value of net assets at end of year (total assets less liabilities) | 2020-06-30 | $7,094,268 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-06-30 | $8,172,943 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-06-30 | No |
| Investment advisory and management fees | 2020-06-30 | $8,689 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-06-30 | $8,531,176 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-06-30 | $8,242,984 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-06-30 | $1,524,832 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-06-30 | $1,824,913 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-06-30 | $1,824,913 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-06-30 | $22,050 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-06-30 | $1,726,833 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-06-30 | $-30,029 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-06-30 | No |
| Contributions received in cash from employer | 2020-06-30 | $11,038,780 |
| Employer contributions (assets) at end of year | 2020-06-30 | $549,912 |
| Employer contributions (assets) at beginning of year | 2020-06-30 | $696,858 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-06-30 | $10,349,131 |
| Contract administrator fees | 2020-06-30 | $247,123 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-06-30 | No |
| Did the plan have assets held for investment | 2020-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-06-30 | No |
| Aggregate proceeds on sale of assets | 2020-06-30 | $9,886,049 |
| Aggregate carrying amount (costs) on sale of assets | 2020-06-30 | $9,886,049 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-06-30 | Unqualified |
| Accountancy firm name | 2020-06-30 | EIDE BAILLY LLP |
| Accountancy firm EIN | 2020-06-30 | 450250958 |
| 2019 : SHOP IRONWORKERS LOCAL 790 WELFARE 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-06-30 | $-25,429 |
| Total unrealized appreciation/depreciation of assets | 2019-06-30 | $-25,429 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $3,332,562 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $2,970,482 |
| Total income from all sources (including contributions) | 2019-06-30 | $12,932,192 |
| Total loss/gain on sale of assets | 2019-06-30 | $25,429 |
| Total of all expenses incurred | 2019-06-30 | $13,336,093 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-06-30 | $12,920,699 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-06-30 | $11,791,880 |
| Value of total assets at end of year | 2019-06-30 | $11,505,505 |
| Value of total assets at beginning of year | 2019-06-30 | $11,547,326 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-06-30 | $415,394 |
| Total interest from all sources | 2019-06-30 | $29,704 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-06-30 | $296,782 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-06-30 | $296,782 |
| Administrative expenses professional fees incurred | 2019-06-30 | $114,819 |
| Was this plan covered by a fidelity bond | 2019-06-30 | Yes |
| Value of fidelity bond cover | 2019-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-06-30 | No |
| Contributions received from participants | 2019-06-30 | $111,515 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-06-30 | $714,167 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-06-30 | $2,029,808 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-06-30 | $3,085,186 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-06-30 | $2,766,602 |
| Other income not declared elsewhere | 2019-06-30 | $604,298 |
| Administrative expenses (other) incurred | 2019-06-30 | $44,591 |
| Liabilities. Value of operating payables at end of year | 2019-06-30 | $247,376 |
| Liabilities. Value of operating payables at beginning of year | 2019-06-30 | $203,880 |
| Total non interest bearing cash at end of year | 2019-06-30 | $26,583 |
| Total non interest bearing cash at beginning of year | 2019-06-30 | $23,091 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Value of net income/loss | 2019-06-30 | $-403,901 |
| Value of net assets at end of year (total assets less liabilities) | 2019-06-30 | $8,172,943 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-06-30 | $8,576,844 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-06-30 | No |
| Investment advisory and management fees | 2019-06-30 | $8,448 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-06-30 | $8,242,984 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-06-30 | $8,206,676 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-06-30 | $1,824,913 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-06-30 | $557,052 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-06-30 | $557,052 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-06-30 | $29,704 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-06-30 | $1,759,231 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-06-30 | $209,528 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-06-30 | No |
| Contributions received in cash from employer | 2019-06-30 | $11,680,365 |
| Employer contributions (assets) at end of year | 2019-06-30 | $696,858 |
| Employer contributions (assets) at beginning of year | 2019-06-30 | $730,699 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-06-30 | $11,161,468 |
| Contract administrator fees | 2019-06-30 | $247,536 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-06-30 | No |
| Did the plan have assets held for investment | 2019-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-06-30 | No |
| Aggregate proceeds on sale of assets | 2019-06-30 | $11,262,249 |
| Aggregate carrying amount (costs) on sale of assets | 2019-06-30 | $11,236,820 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-06-30 | Unqualified |
| Accountancy firm name | 2019-06-30 | EIDE BAILLY LLP |
| Accountancy firm EIN | 2019-06-30 | 450250958 |
| 2018 : SHOP IRONWORKERS LOCAL 790 WELFARE 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $2,970,482 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $3,307,848 |
| Total income from all sources (including contributions) | 2018-06-30 | $14,572,891 |
| Total loss/gain on sale of assets | 2018-06-30 | $0 |
| Total of all expenses incurred | 2018-06-30 | $14,152,347 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-06-30 | $13,726,511 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-06-30 | $12,095,490 |
| Value of total assets at end of year | 2018-06-30 | $11,547,326 |
| Value of total assets at beginning of year | 2018-06-30 | $11,464,148 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-06-30 | $425,836 |
| Total interest from all sources | 2018-06-30 | $5,983 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-06-30 | $331,317 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-06-30 | $331,317 |
| Administrative expenses professional fees incurred | 2018-06-30 | $103,305 |
| Was this plan covered by a fidelity bond | 2018-06-30 | Yes |
| Value of fidelity bond cover | 2018-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2018-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-06-30 | No |
| Contributions received from participants | 2018-06-30 | $106,051 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-06-30 | $2,029,808 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-06-30 | $63,418 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-06-30 | $2,766,602 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-06-30 | $3,069,643 |
| Other income not declared elsewhere | 2018-06-30 | $2,225,171 |
| Administrative expenses (other) incurred | 2018-06-30 | $42,078 |
| Liabilities. Value of operating payables at end of year | 2018-06-30 | $203,880 |
| Liabilities. Value of operating payables at beginning of year | 2018-06-30 | $238,205 |
| Total non interest bearing cash at end of year | 2018-06-30 | $23,091 |
| Total non interest bearing cash at beginning of year | 2018-06-30 | $14,211 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Value of net income/loss | 2018-06-30 | $420,544 |
| Value of net assets at end of year (total assets less liabilities) | 2018-06-30 | $8,576,844 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-06-30 | $8,156,300 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-06-30 | No |
| Investment advisory and management fees | 2018-06-30 | $7,721 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-06-30 | $8,206,676 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-06-30 | $9,786,767 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-06-30 | $557,052 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-06-30 | $887,639 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-06-30 | $887,639 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-06-30 | $5,983 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-06-30 | $1,703,561 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-06-30 | $-85,070 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-06-30 | No |
| Contributions received in cash from employer | 2018-06-30 | $11,989,439 |
| Employer contributions (assets) at end of year | 2018-06-30 | $730,699 |
| Employer contributions (assets) at beginning of year | 2018-06-30 | $712,113 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-06-30 | $12,022,950 |
| Contract administrator fees | 2018-06-30 | $272,732 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-06-30 | No |
| Did the plan have assets held for investment | 2018-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-06-30 | No |
| Aggregate proceeds on sale of assets | 2018-06-30 | $12,906,560 |
| Aggregate carrying amount (costs) on sale of assets | 2018-06-30 | $12,906,560 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-06-30 | Unqualified |
| Accountancy firm name | 2018-06-30 | VAVRINEK, TRINE, DAY & CO., LLP |
| Accountancy firm EIN | 2018-06-30 | 952648289 |
| 2017 : SHOP IRONWORKERS LOCAL 790 WELFARE 2017 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $3,307,848 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $3,314,925 |
| Total income from all sources (including contributions) | 2017-06-30 | $12,398,956 |
| Total loss/gain on sale of assets | 2017-06-30 | $0 |
| Total of all expenses incurred | 2017-06-30 | $13,327,085 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-06-30 | $12,855,992 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-06-30 | $11,765,093 |
| Value of total assets at end of year | 2017-06-30 | $11,464,148 |
| Value of total assets at beginning of year | 2017-06-30 | $12,399,354 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-06-30 | $471,093 |
| Total interest from all sources | 2017-06-30 | $2,141 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-06-30 | $355,921 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-06-30 | $355,921 |
| Administrative expenses professional fees incurred | 2017-06-30 | $91,043 |
| Was this plan covered by a fidelity bond | 2017-06-30 | Yes |
| Value of fidelity bond cover | 2017-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-06-30 | No |
| Contributions received from participants | 2017-06-30 | $132,244 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-06-30 | $63,418 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-06-30 | $29,680 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-06-30 | $3,069,643 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-06-30 | $3,142,530 |
| Administrative expenses (other) incurred | 2017-06-30 | $115,121 |
| Liabilities. Value of operating payables at end of year | 2017-06-30 | $238,205 |
| Liabilities. Value of operating payables at beginning of year | 2017-06-30 | $172,395 |
| Total non interest bearing cash at end of year | 2017-06-30 | $14,211 |
| Total non interest bearing cash at beginning of year | 2017-06-30 | $5,727 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Value of net income/loss | 2017-06-30 | $-928,129 |
| Value of net assets at end of year (total assets less liabilities) | 2017-06-30 | $8,156,300 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-06-30 | $9,084,429 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-06-30 | No |
| Investment advisory and management fees | 2017-06-30 | $4,963 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-06-30 | $9,786,767 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-06-30 | $10,956,032 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-06-30 | $887,639 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-06-30 | $769,488 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-06-30 | $769,488 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-06-30 | $2,141 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-06-30 | $1,807,749 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-06-30 | $275,801 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-06-30 | No |
| Contributions received in cash from employer | 2017-06-30 | $11,632,849 |
| Employer contributions (assets) at end of year | 2017-06-30 | $712,113 |
| Employer contributions (assets) at beginning of year | 2017-06-30 | $638,427 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-06-30 | $11,048,243 |
| Contract administrator fees | 2017-06-30 | $259,966 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-06-30 | No |
| Did the plan have assets held for investment | 2017-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-06-30 | No |
| Aggregate proceeds on sale of assets | 2017-06-30 | $10,494,913 |
| Aggregate carrying amount (costs) on sale of assets | 2017-06-30 | $10,494,913 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-06-30 | Unqualified |
| Accountancy firm name | 2017-06-30 | VAVRINEK, TRINE, DAY & CO., LLP |
| Accountancy firm EIN | 2017-06-30 | 952648289 |
| 2016 : SHOP IRONWORKERS LOCAL 790 WELFARE 2016 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $3,314,925 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $3,738,863 |
| Total income from all sources (including contributions) | 2016-06-30 | $12,273,886 |
| Total loss/gain on sale of assets | 2016-06-30 | $0 |
| Total of all expenses incurred | 2016-06-30 | $13,012,595 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-06-30 | $12,482,134 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-06-30 | $11,768,863 |
| Value of total assets at end of year | 2016-06-30 | $12,399,354 |
| Value of total assets at beginning of year | 2016-06-30 | $13,562,001 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-06-30 | $530,461 |
| Total interest from all sources | 2016-06-30 | $1,158 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-06-30 | $495,828 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-06-30 | $495,828 |
| Administrative expenses professional fees incurred | 2016-06-30 | $102,390 |
| Was this plan covered by a fidelity bond | 2016-06-30 | Yes |
| Value of fidelity bond cover | 2016-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-06-30 | No |
| Contributions received from participants | 2016-06-30 | $225,644 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-06-30 | $29,680 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-06-30 | $171,139 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-06-30 | $3,142,530 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-06-30 | $3,508,000 |
| Other income not declared elsewhere | 2016-06-30 | $138,354 |
| Administrative expenses (other) incurred | 2016-06-30 | $151,790 |
| Liabilities. Value of operating payables at end of year | 2016-06-30 | $172,395 |
| Liabilities. Value of operating payables at beginning of year | 2016-06-30 | $230,863 |
| Total non interest bearing cash at end of year | 2016-06-30 | $5,727 |
| Total non interest bearing cash at beginning of year | 2016-06-30 | $23,705 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Value of net income/loss | 2016-06-30 | $-738,709 |
| Value of net assets at end of year (total assets less liabilities) | 2016-06-30 | $9,084,429 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-06-30 | $9,823,138 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-06-30 | No |
| Investment advisory and management fees | 2016-06-30 | $7,651 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-06-30 | $10,956,032 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-06-30 | $12,002,293 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-06-30 | $769,488 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-06-30 | $751,435 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-06-30 | $751,435 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-06-30 | $1,158 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-06-30 | $1,953,408 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-06-30 | $-130,317 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-06-30 | No |
| Contributions received in cash from employer | 2016-06-30 | $11,543,219 |
| Employer contributions (assets) at end of year | 2016-06-30 | $638,427 |
| Employer contributions (assets) at beginning of year | 2016-06-30 | $613,429 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-06-30 | $10,528,726 |
| Contract administrator fees | 2016-06-30 | $268,630 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-06-30 | No |
| Did the plan have assets held for investment | 2016-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-06-30 | No |
| Aggregate proceeds on sale of assets | 2016-06-30 | $10,574,505 |
| Aggregate carrying amount (costs) on sale of assets | 2016-06-30 | $10,574,505 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-06-30 | Unqualified |
| Accountancy firm name | 2016-06-30 | HEMMING MORSE CPAS AND CONSULTANTS |
| Accountancy firm EIN | 2016-06-30 | 300702322 |
| 2015 : SHOP IRONWORKERS LOCAL 790 WELFARE 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-06-30 | $-182,101 |
| Total unrealized appreciation/depreciation of assets | 2015-06-30 | $-182,101 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $2,698,863 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $2,588,079 |
| Total income from all sources (including contributions) | 2015-06-30 | $11,838,375 |
| Total loss/gain on sale of assets | 2015-06-30 | $133,217 |
| Total of all expenses incurred | 2015-06-30 | $11,611,725 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-06-30 | $11,270,858 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-06-30 | $11,467,435 |
| Value of total assets at end of year | 2015-06-30 | $13,562,001 |
| Value of total assets at beginning of year | 2015-06-30 | $13,224,567 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-06-30 | $340,867 |
| Total interest from all sources | 2015-06-30 | $498 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-06-30 | $419,326 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-06-30 | $419,326 |
| Administrative expenses professional fees incurred | 2015-06-30 | $133,267 |
| Was this plan covered by a fidelity bond | 2015-06-30 | Yes |
| Value of fidelity bond cover | 2015-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-06-30 | No |
| Contributions received from participants | 2015-06-30 | $222,540 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2015-06-30 | $243,767 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-06-30 | $9,844 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-06-30 | $35,790 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-06-30 | $268,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-06-30 | $191,000 |
| Administrative expenses (other) incurred | 2015-06-30 | $19,364 |
| Liabilities. Value of operating payables at end of year | 2015-06-30 | $230,863 |
| Liabilities. Value of operating payables at beginning of year | 2015-06-30 | $97,079 |
| Total non interest bearing cash at end of year | 2015-06-30 | $185,000 |
| Total non interest bearing cash at beginning of year | 2015-06-30 | $27,218 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Value of net income/loss | 2015-06-30 | $226,650 |
| Value of net assets at end of year (total assets less liabilities) | 2015-06-30 | $10,863,138 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-06-30 | $10,636,488 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-06-30 | No |
| Investment advisory and management fees | 2015-06-30 | $15,750 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-06-30 | $12,002,293 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-06-30 | $11,016,358 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-06-30 | $751,435 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-06-30 | $1,527,466 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-06-30 | $1,527,466 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-06-30 | $498 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-06-30 | $3,131,748 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-06-30 | No |
| Contributions received in cash from employer | 2015-06-30 | $11,244,895 |
| Employer contributions (assets) at end of year | 2015-06-30 | $613,429 |
| Employer contributions (assets) at beginning of year | 2015-06-30 | $617,735 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-06-30 | $7,895,343 |
| Contract administrator fees | 2015-06-30 | $172,486 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2015-06-30 | $2,200,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-06-30 | $2,300,000 |
| Did the plan have assets held for investment | 2015-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-06-30 | No |
| Aggregate proceeds on sale of assets | 2015-06-30 | $547,834 |
| Aggregate carrying amount (costs) on sale of assets | 2015-06-30 | $414,617 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-06-30 | Unqualified |
| Accountancy firm name | 2015-06-30 | BERNARD KOTKIN & COMPANY, LLP |
| Accountancy firm EIN | 2015-06-30 | 952556670 |
| 2014 : SHOP IRONWORKERS LOCAL 790 WELFARE 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-06-30 | $237,336 |
| Total unrealized appreciation/depreciation of assets | 2014-06-30 | $237,336 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $2,588,079 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $1,875,758 |
| Total income from all sources (including contributions) | 2014-06-30 | $9,762,065 |
| Total loss/gain on sale of assets | 2014-06-30 | $191,087 |
| Total of all expenses incurred | 2014-06-30 | $9,493,911 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-06-30 | $9,173,613 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-06-30 | $9,049,265 |
| Value of total assets at end of year | 2014-06-30 | $13,224,567 |
| Value of total assets at beginning of year | 2014-06-30 | $12,244,092 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-06-30 | $320,298 |
| Total interest from all sources | 2014-06-30 | $444 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-06-30 | $283,933 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-06-30 | $283,933 |
| Administrative expenses professional fees incurred | 2014-06-30 | $125,340 |
| Was this plan covered by a fidelity bond | 2014-06-30 | Yes |
| Value of fidelity bond cover | 2014-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-06-30 | No |
| Contributions received from participants | 2014-06-30 | $160,445 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-06-30 | $99,850 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-06-30 | $35,790 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-06-30 | $654,200 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-06-30 | $191,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-06-30 | $170,000 |
| Administrative expenses (other) incurred | 2014-06-30 | $11,587 |
| Liabilities. Value of operating payables at end of year | 2014-06-30 | $97,079 |
| Liabilities. Value of operating payables at beginning of year | 2014-06-30 | $105,758 |
| Total non interest bearing cash at end of year | 2014-06-30 | $27,218 |
| Total non interest bearing cash at beginning of year | 2014-06-30 | $119,697 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Value of net income/loss | 2014-06-30 | $268,154 |
| Value of net assets at end of year (total assets less liabilities) | 2014-06-30 | $10,636,488 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-06-30 | $10,368,334 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-06-30 | No |
| Investment advisory and management fees | 2014-06-30 | $17,769 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-06-30 | $11,016,358 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-06-30 | $10,287,160 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-06-30 | $1,527,466 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-06-30 | $655,523 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-06-30 | $655,523 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-06-30 | $444 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-06-30 | $3,202,841 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-06-30 | No |
| Contributions received in cash from employer | 2014-06-30 | $8,888,820 |
| Employer contributions (assets) at end of year | 2014-06-30 | $617,735 |
| Employer contributions (assets) at beginning of year | 2014-06-30 | $527,512 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-06-30 | $5,870,922 |
| Contract administrator fees | 2014-06-30 | $165,602 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2014-06-30 | $2,300,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-06-30 | $1,600,000 |
| Did the plan have assets held for investment | 2014-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-06-30 | No |
| Aggregate proceeds on sale of assets | 2014-06-30 | $9,345,666 |
| Aggregate carrying amount (costs) on sale of assets | 2014-06-30 | $9,154,579 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-06-30 | Unqualified |
| Accountancy firm name | 2014-06-30 | BERNARD KOTKIN & COMPANY, LLP |
| Accountancy firm EIN | 2014-06-30 | 952556670 |
| 2013 : SHOP IRONWORKERS LOCAL 790 WELFARE 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-06-30 | $-408,852 |
| Total unrealized appreciation/depreciation of assets | 2013-06-30 | $-408,852 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $1,875,758 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $2,340,205 |
| Total income from all sources (including contributions) | 2013-06-30 | $7,997,067 |
| Total loss/gain on sale of assets | 2013-06-30 | $389,677 |
| Total of all expenses incurred | 2013-06-30 | $8,005,468 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-06-30 | $7,743,264 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-06-30 | $7,627,912 |
| Value of total assets at end of year | 2013-06-30 | $12,244,092 |
| Value of total assets at beginning of year | 2013-06-30 | $12,716,940 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-06-30 | $262,204 |
| Total interest from all sources | 2013-06-30 | $590 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-06-30 | $387,725 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-06-30 | $387,725 |
| Administrative expenses professional fees incurred | 2013-06-30 | $87,912 |
| Was this plan covered by a fidelity bond | 2013-06-30 | Yes |
| Value of fidelity bond cover | 2013-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-06-30 | No |
| Contributions received from participants | 2013-06-30 | $229,255 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-06-30 | $79,004 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-06-30 | $654,200 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-06-30 | $47,010 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-06-30 | $170,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-06-30 | $166,000 |
| Other income not declared elsewhere | 2013-06-30 | $15 |
| Administrative expenses (other) incurred | 2013-06-30 | $10,560 |
| Liabilities. Value of operating payables at end of year | 2013-06-30 | $105,758 |
| Liabilities. Value of operating payables at beginning of year | 2013-06-30 | $74,205 |
| Total non interest bearing cash at end of year | 2013-06-30 | $119,697 |
| Total non interest bearing cash at beginning of year | 2013-06-30 | $120,592 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Value of net income/loss | 2013-06-30 | $-8,401 |
| Value of net assets at end of year (total assets less liabilities) | 2013-06-30 | $10,368,334 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-06-30 | $10,376,735 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-06-30 | No |
| Investment advisory and management fees | 2013-06-30 | $10,829 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-06-30 | $10,287,160 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-06-30 | $11,456,611 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-06-30 | $655,523 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-06-30 | $596,999 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-06-30 | $596,999 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-06-30 | $590 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-06-30 | $1,955,361 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-06-30 | No |
| Contributions received in cash from employer | 2013-06-30 | $7,398,657 |
| Employer contributions (assets) at end of year | 2013-06-30 | $527,512 |
| Employer contributions (assets) at beginning of year | 2013-06-30 | $495,728 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-06-30 | $5,708,899 |
| Contract administrator fees | 2013-06-30 | $152,903 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2013-06-30 | $1,600,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-06-30 | $2,100,000 |
| Did the plan have assets held for investment | 2013-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-06-30 | No |
| Aggregate proceeds on sale of assets | 2013-06-30 | $1,756,492 |
| Aggregate carrying amount (costs) on sale of assets | 2013-06-30 | $1,366,815 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-06-30 | Unqualified |
| Accountancy firm name | 2013-06-30 | BERNARD KOTKIN & COMPANY,LLP |
| Accountancy firm EIN | 2013-06-30 | 952556670 |
| 2012 : SHOP IRONWORKERS LOCAL 790 WELFARE 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-06-30 | $332,010 |
| Total unrealized appreciation/depreciation of assets | 2012-06-30 | $332,010 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $2,340,205 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $2,435,737 |
| Total income from all sources (including contributions) | 2012-06-30 | $8,967,891 |
| Total of all expenses incurred | 2012-06-30 | $7,066,912 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-06-30 | $6,812,516 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-06-30 | $8,242,728 |
| Value of total assets at end of year | 2012-06-30 | $12,716,940 |
| Value of total assets at beginning of year | 2012-06-30 | $10,911,493 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-06-30 | $254,396 |
| Total interest from all sources | 2012-06-30 | $1,061 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-06-30 | $390,349 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-06-30 | $390,349 |
| Administrative expenses professional fees incurred | 2012-06-30 | $81,541 |
| Was this plan covered by a fidelity bond | 2012-06-30 | Yes |
| Value of fidelity bond cover | 2012-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2012-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-06-30 | No |
| Contributions received from participants | 2012-06-30 | $166,668 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-06-30 | $74,138 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-06-30 | $47,010 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-06-30 | $49,137 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-06-30 | $166,000 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-06-30 | $61,600 |
| Other income not declared elsewhere | 2012-06-30 | $1,743 |
| Administrative expenses (other) incurred | 2012-06-30 | $7,516 |
| Liabilities. Value of operating payables at end of year | 2012-06-30 | $74,205 |
| Liabilities. Value of operating payables at beginning of year | 2012-06-30 | $74,137 |
| Total non interest bearing cash at end of year | 2012-06-30 | $120,592 |
| Total non interest bearing cash at beginning of year | 2012-06-30 | $124,046 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Value of net income/loss | 2012-06-30 | $1,900,979 |
| Value of net assets at end of year (total assets less liabilities) | 2012-06-30 | $10,376,735 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-06-30 | $8,475,756 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-06-30 | No |
| Investment advisory and management fees | 2012-06-30 | $11,926 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-06-30 | $11,456,611 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-06-30 | $9,656,251 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-06-30 | $596,999 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-06-30 | $558,824 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-06-30 | $558,824 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-06-30 | $1,061 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-06-30 | $2,089,104 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-06-30 | No |
| Contributions received in cash from employer | 2012-06-30 | $8,076,060 |
| Employer contributions (assets) at end of year | 2012-06-30 | $495,728 |
| Employer contributions (assets) at beginning of year | 2012-06-30 | $523,235 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-06-30 | $4,649,274 |
| Contract administrator fees | 2012-06-30 | $153,413 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2012-06-30 | $2,100,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-06-30 | $2,300,000 |
| Did the plan have assets held for investment | 2012-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-06-30 | Unqualified |
| Accountancy firm name | 2012-06-30 | BERNARD KOTKIN & COMPANY, LLP |
| Accountancy firm EIN | 2012-06-30 | 952556670 |
| 2011 : SHOP IRONWORKERS LOCAL 790 WELFARE 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-06-30 | $-258,061 |
| Total unrealized appreciation/depreciation of assets | 2011-06-30 | $-258,061 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $2,435,737 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $2,452,839 |
| Total income from all sources (including contributions) | 2011-06-30 | $7,099,992 |
| Total loss/gain on sale of assets | 2011-06-30 | $625,250 |
| Total of all expenses incurred | 2011-06-30 | $5,532,508 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-06-30 | $5,287,722 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-06-30 | $6,347,762 |
| Value of total assets at end of year | 2011-06-30 | $10,911,493 |
| Value of total assets at beginning of year | 2011-06-30 | $9,361,111 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-06-30 | $244,786 |
| Total interest from all sources | 2011-06-30 | $1,397 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-06-30 | $274,895 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-06-30 | $274,895 |
| Administrative expenses professional fees incurred | 2011-06-30 | $88,831 |
| Was this plan covered by a fidelity bond | 2011-06-30 | Yes |
| Value of fidelity bond cover | 2011-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-06-30 | No |
| Contributions received from participants | 2011-06-30 | $143,386 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-06-30 | $49,137 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-06-30 | $54,014 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-06-30 | $61,600 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-06-30 | $54,560 |
| Other income not declared elsewhere | 2011-06-30 | $108,749 |
| Administrative expenses (other) incurred | 2011-06-30 | $12,605 |
| Liabilities. Value of operating payables at end of year | 2011-06-30 | $74,137 |
| Liabilities. Value of operating payables at beginning of year | 2011-06-30 | $48,279 |
| Total non interest bearing cash at end of year | 2011-06-30 | $124,046 |
| Total non interest bearing cash at beginning of year | 2011-06-30 | $210,860 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Value of net income/loss | 2011-06-30 | $1,567,484 |
| Value of net assets at end of year (total assets less liabilities) | 2011-06-30 | $8,475,756 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-06-30 | $6,908,272 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-06-30 | No |
| Investment advisory and management fees | 2011-06-30 | $10,626 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-06-30 | $9,656,251 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-06-30 | $8,469,110 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-06-30 | $558,824 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-06-30 | $186,050 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-06-30 | $186,050 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-06-30 | $1,397 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-06-30 | $1,591,852 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-06-30 | No |
| Contributions received in cash from employer | 2011-06-30 | $6,204,376 |
| Employer contributions (assets) at end of year | 2011-06-30 | $523,235 |
| Employer contributions (assets) at beginning of year | 2011-06-30 | $441,077 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-06-30 | $3,695,870 |
| Contract administrator fees | 2011-06-30 | $132,724 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2011-06-30 | $2,300,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-06-30 | $2,350,000 |
| Did the plan have assets held for investment | 2011-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-06-30 | No |
| Aggregate proceeds on sale of assets | 2011-06-30 | $1,746,564 |
| Aggregate carrying amount (costs) on sale of assets | 2011-06-30 | $1,121,314 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-06-30 | Unqualified |
| Accountancy firm name | 2011-06-30 | BERNARD KOTKIN & COMPANY, LLP |
| Accountancy firm EIN | 2011-06-30 | 952556670 |
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 1 |
| Insurance contract or identification number | 276055 | | Number of Individuals Covered | 598 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $132,849 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337027 |
| Policy instance | 2 |
| Insurance contract or identification number | 3337027 | | Number of Individuals Covered | 474 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $390,354 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STHEALTH/CHARTIS (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 47-MSL-000493-0 |
| Policy instance | 3 |
| Insurance contract or identification number | 47-MSL-000493-0 | | Number of Individuals Covered | 598 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Welfare Benefit Premiums Paid to Carrier | USD $679,465 | | 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 number | 7021 |
| Policy instance | 4 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,249 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 008823 |
| Policy instance | 5 |
| Insurance contract or identification number | 008823 | | Number of Individuals Covered | 602 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Other welfare benefits provided | MENTAL HEALTH AND SUBSTANCE ABUSE | | Welfare Benefit Premiums Paid to Carrier | USD $29,042 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 6 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 602 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,095 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 7 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 62 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,562 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STHEALTH/CHARTIS (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 47-MSL-000493-0 |
| Policy instance | 3 |
| Insurance contract or identification number | 47-MSL-000493-0 | | Number of Individuals Covered | 609 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2021-06-30 | | Welfare Benefit Premiums Paid to Carrier | USD $645,987 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337027 |
| Policy instance | 2 |
| Insurance contract or identification number | 3337027 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $501,274 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 7021 |
| Policy instance | 4 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,487 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 008823 |
| Policy instance | 5 |
| Insurance contract or identification number | 008823 | | Number of Individuals Covered | 622 | | Other welfare benefits provided | MENTAL HEALTH AND SUBSTANCE ABUSE | | Welfare Benefit Premiums Paid to Carrier | USD $22,472 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 6 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 622 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,781 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 7 |
| Insurance contract or identification number | 711894 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,686 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 1 |
| Insurance contract or identification number | 276055 | | Number of Individuals Covered | 609 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $129,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 2 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 685 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $39,327 | | 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 number | 7021 |
| Policy instance | 1 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $29,245 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 8823 |
| Policy instance | 3 |
| Insurance contract or identification number | 8823 | | Number of Individuals Covered | 630 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $26,971 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337027 |
| Policy instance | 4 |
| Insurance contract or identification number | 3337027 | | Number of Individuals Covered | 488 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $613,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 5 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,897 | | 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 number | HCL17187 |
| Policy instance | 6 |
| Insurance contract or identification number | HCL17187 | | Number of Individuals Covered | 603 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $553,621 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 7 |
| Insurance contract or identification number | 276055 | | Number of Individuals Covered | 602 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $135,917 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA DENTAL HEALTH OF CALIFORNIA,INC (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 3337027 |
| Policy instance | 8 |
| Insurance contract or identification number | 3337027 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 8823 |
| Policy instance | 3 |
| Insurance contract or identification number | 8823 | | Number of Individuals Covered | 768 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $30,668 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337027 |
| Policy instance | 4 |
| Insurance contract or identification number | 3337027 | | Number of Individuals Covered | 646 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $815,338 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 5 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,113 | | 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 number | 7021 |
| Policy instance | 1 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $28,015 | | 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 number | HCL17187 |
| Policy instance | 6 |
| Insurance contract or identification number | HCL17187 | | Number of Individuals Covered | 815 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | Total amount of commissions paid to insurance broker | USD $55,866 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $592,422 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,866 | | Insurance broker organization code? | 3 |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 7 |
| Insurance contract or identification number | 276055 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $237,101 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0717403 |
| Policy instance | 8 |
| Insurance contract or identification number | 0717403 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,660 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 2 |
| Insurance contract or identification number | 63437-9 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 8 |
| Insurance contract or identification number | 276055 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,250 | | 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 number | HCL17187 |
| Policy instance | 7 |
| Insurance contract or identification number | HCL17187 | | Number of Individuals Covered | 815 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $55,866 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $592,422 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,866 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 6 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,681 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337027 |
| Policy instance | 5 |
| Insurance contract or identification number | 3337027 | | Number of Individuals Covered | 663 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $807,450 | | 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 number | 00182000 |
| Policy instance | 4 |
| Insurance contract or identification number | 00182000 | | Number of Individuals Covered | 747 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $62,403 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 8823 |
| Policy instance | 3 |
| Insurance contract or identification number | 8823 | | Number of Individuals Covered | 828 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $31,982 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 2 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 831 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $44,493 | | 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 number | 7021 |
| Policy instance | 1 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $29,712 | | 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 number | 7021 |
| Policy instance | 1 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $28,644 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 8 |
| Insurance contract or identification number | 276055 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $158,678 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 2 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 905 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $48,189 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 8823 |
| Policy instance | 3 |
| Insurance contract or identification number | 8823 | | Number of Individuals Covered | 838 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $32,199 | | 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 number | 00182000 |
| Policy instance | 4 |
| Insurance contract or identification number | 00182000 | | Number of Individuals Covered | 770 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,866 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337027 |
| Policy instance | 5 |
| Insurance contract or identification number | 3337027 | | Number of Individuals Covered | 682 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $822,885 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 6 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,724 | | 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 number | HCL17187 |
| Policy instance | 7 |
| Insurance contract or identification number | HCL17187 | | Number of Individuals Covered | 841 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $51,027 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $449,799 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 8 |
| Insurance contract or identification number | 276055 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $173,615 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 2 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 994 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $51,132 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 7021 |
| Policy instance | 1 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $42,201 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 0012000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0012000 | | Number of Individuals Covered | 847 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,527 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337027 |
| Policy instance | 5 |
| Insurance contract or identification number | 3337027 | | Number of Individuals Covered | 744 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $914,492 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| UNITED HEALTH CARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 6 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 275 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $65,028 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL17187 |
| Policy instance | 7 |
| Insurance contract or identification number | HCL17187 | | Number of Individuals Covered | 928 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $47,115 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $588,938 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,115 | | Insurance broker organization code? | 3 | | Insurance broker name | STOP LOSS INSURANCE SERVICES, INC |
|
| MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 8823 |
| Policy instance | 3 |
| Insurance contract or identification number | 8823 | | Number of Individuals Covered | 983 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 44331 |
| Policy instance | 9 |
| Insurance contract or identification number | 44331 | | Number of Individuals Covered | 742 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $859,055 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 5 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,922 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 8 |
| Insurance contract or identification number | 276055 | | Number of Individuals Covered | 993 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $164,804 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STOP LOSS INSURANCE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 0063437-9 |
| Policy instance | 7 |
| Insurance contract or identification number | 0063437-9 | | Number of Individuals Covered | 983 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $580,886 | | 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 number | 182000 |
| Policy instance | 6 |
| Insurance contract or identification number | 182000 | | Number of Individuals Covered | 848 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $81,165 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 70050008823 |
| Policy instance | 4 |
| Insurance contract or identification number | 70050008823 | | Number of Individuals Covered | 997 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | DRUG DEPENDENCY PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $35,465 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 3 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 968 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $49,760 | | 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 number | 7021 |
| Policy instance | 2 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $52,010 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLDYNE RX (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | SHOPIRON |
| Policy instance | 1 |
| Insurance contract or identification number | SHOPIRON | | Number of Individuals Covered | 1036 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,144,681 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 44331 |
| Policy instance | 9 |
| Insurance contract or identification number | 44331 | | Number of Individuals Covered | 643 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $617,545 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLDYNE RX (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | SHOPIRON |
| Policy instance | 1 |
| Insurance contract or identification number | SHOPIRON | | Number of Individuals Covered | 833 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $921,724 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 3 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 858 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $43,371 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 70050008823 |
| Policy instance | 4 |
| Insurance contract or identification number | 70050008823 | | Number of Individuals Covered | 874 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | DRUG DEPENDENCY PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $30,875 | | 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 number | 7021 |
| Policy instance | 2 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 5 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 101 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,479 | | 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 number | 182000 |
| Policy instance | 6 |
| Insurance contract or identification number | 182000 | | Number of Individuals Covered | 744 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $70,247 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STOP LOSS INSURANCE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 0063437-9 |
| Policy instance | 7 |
| Insurance contract or identification number | 0063437-9 | | Number of Individuals Covered | 860 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $475,840 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 8 |
| Insurance contract or identification number | 276055 | | Number of Individuals Covered | 873 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $138,253 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 44331 |
| Policy instance | 11 |
| Insurance contract or identification number | 44331 | | Number of Individuals Covered | 501 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,352 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 276055 |
| Policy instance | 10 |
| Insurance contract or identification number | 276055 | | Number of Individuals Covered | 697 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $114,902 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STOP LOSS INSURANCE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 0063437-9 |
| Policy instance | 9 |
| Insurance contract or identification number | 0063437-9 | | Number of Individuals Covered | 691 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $372,490 | | 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 number | 182000 |
| Policy instance | 8 |
| Insurance contract or identification number | 182000 | | Number of Individuals Covered | 574 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $67,830 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 01023-0001 |
| Policy instance | 7 |
| Insurance contract or identification number | 01023-0001 | | Number of Individuals Covered | 66 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,339 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 6 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,754 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 70050008823 |
| Policy instance | 5 |
| Insurance contract or identification number | 70050008823 | | Number of Individuals Covered | 705 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | DRUG DEPENDENCY PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $138,791 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 4 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 676 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $36,498 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4923-0001 |
| Policy instance | 3 |
| Insurance contract or identification number | 4923-0001 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $637,346 | | 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 number | 7021 |
| Policy instance | 2 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,437 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLDYNE RX (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | SHOPIRON |
| Policy instance | 1 |
| Insurance contract or identification number | SHOPIRON | | Number of Individuals Covered | 833 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $828,622 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLDYNE RX (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | SHOPIRON |
| Policy instance | 1 |
| Insurance contract or identification number | SHOPIRON | | Number of Individuals Covered | 765 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $818,381 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4923-0001 |
| Policy instance | 3 |
| Insurance contract or identification number | 4923-0001 | | Number of Individuals Covered | 519 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $537,006 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 4 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 707 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $37,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 6 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 107 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $60,146 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 70050008823 |
| Policy instance | 5 |
| Insurance contract or identification number | 70050008823 | | Number of Individuals Covered | 733 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | DRUG DEPENDENCY PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $106,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 01023-0001 |
| Policy instance | 7 |
| Insurance contract or identification number | 01023-0001 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,858 | | 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 number | 182000 |
| Policy instance | 8 |
| Insurance contract or identification number | 182000 | | Number of Individuals Covered | 693 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $69,743 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STOP LOSS INSURANCE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 0063437-9 |
| Policy instance | 9 |
| Insurance contract or identification number | 0063437-9 | | Number of Individuals Covered | 720 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $371,657 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | N/A |
| Policy instance | 10 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 724 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $111,600 | | 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 number | 7021 |
| Policy instance | 2 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $53,592 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLDYNE RX (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | SHOPIRON |
| Policy instance | 1 |
| Insurance contract or identification number | SHOPIRON | | Number of Individuals Covered | 606 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $563,291 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STOP LOSS INSURANCE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 0063437-9 |
| Policy instance | 9 |
| Insurance contract or identification number | 0063437-9 | | Number of Individuals Covered | 611 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $255,102 | | 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 number | 182000 |
| Policy instance | 8 |
| Insurance contract or identification number | 182000 | | Number of Individuals Covered | 656 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,792 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 01023-0001 |
| Policy instance | 7 |
| Insurance contract or identification number | 01023-0001 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,745 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 711894 |
| Policy instance | 6 |
| Insurance contract or identification number | 711894 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $60,177 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | 70050008823 |
| Policy instance | 5 |
| Insurance contract or identification number | 70050008823 | | Number of Individuals Covered | 623 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | DRUG DEPENDENCY PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $89,134 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 63437-9 |
| Policy instance | 4 |
| Insurance contract or identification number | 63437-9 | | Number of Individuals Covered | 601 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $67,298 | | 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 number | 7021 |
| Policy instance | 2 |
| Insurance contract or identification number | 7021 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $61,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4923-0001 |
| Policy instance | 3 |
| Insurance contract or identification number | 4923-0001 | | Number of Individuals Covered | 449 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $408,485 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
