SAN YSIDRO HEALTH CENTER, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN
401k plan membership statisitcs for SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2023: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-05-01 | 2,132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-05-01 | 2,336 |
| Number of retired or separated participants receiving benefits | 2023-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-05-01 | 0 |
| Total of all active and inactive participants | 2023-05-01 | 2,336 |
| Number of employers contributing to the scheme | 2023-05-01 | 0 |
| 2022: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-05-01 | 1,979 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-05-01 | 2,152 |
| Number of retired or separated participants receiving benefits | 2022-05-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2022-05-01 | 1 |
| Total of all active and inactive participants | 2022-05-01 | 2,154 |
| Number of employers contributing to the scheme | 2022-05-01 | 0 |
| 2021: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-05-01 | 2,000 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 1,783 |
| Number of retired or separated participants receiving benefits | 2021-05-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2021-05-01 | 2 |
| Total of all active and inactive participants | 2021-05-01 | 1,788 |
| Number of employers contributing to the scheme | 2021-05-01 | 0 |
| 2020: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-05-01 | 1,037 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 1,333 |
| Number of retired or separated participants receiving benefits | 2020-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 0 |
| Total of all active and inactive participants | 2020-05-01 | 1,333 |
| Number of employers contributing to the scheme | 2020-05-01 | 0 |
| 2019: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-05-01 | 1,361 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 1,400 |
| Total of all active and inactive participants | 2019-05-01 | 1,400 |
| Total participants | 2019-05-01 | 1,400 |
| 2018: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2018 401k membership |
|---|
| Number of retired or separated participants receiving benefits | 2018-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-05-01 | 0 |
| Number of employers contributing to the scheme | 2018-05-01 | 0 |
| 2017: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-05-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 1,123 |
| Total of all active and inactive participants | 2017-05-01 | 1,123 |
| Total participants | 2017-05-01 | 1,123 |
| Number of retired or separated participants receiving benefits | 2017-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-05-01 | 0 |
| Number of employers contributing to the scheme | 2017-05-01 | 0 |
| 2016: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-05-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 1,127 |
| Total of all active and inactive participants | 2016-05-01 | 1,127 |
| Total participants | 2016-05-01 | 1,127 |
| Number of retired or separated participants receiving benefits | 2016-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-05-01 | 0 |
| Number of employers contributing to the scheme | 2016-05-01 | 0 |
| 2015: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 983 |
| Total of all active and inactive participants | 2015-05-01 | 983 |
| Total participants | 2015-05-01 | 0 |
| Number of retired or separated participants receiving benefits | 2015-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-05-01 | 0 |
| Number of employers contributing to the scheme | 2015-05-01 | 0 |
| 2014: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 927 |
| Total of all active and inactive participants | 2014-05-01 | 927 |
| Total participants | 2014-05-01 | 0 |
| Number of retired or separated participants receiving benefits | 2014-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-05-01 | 0 |
| Number of employers contributing to the scheme | 2014-05-01 | 0 |
| 2013: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 734 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 761 |
| Total of all active and inactive participants | 2013-05-01 | 761 |
| Total participants | 2013-05-01 | 0 |
| Number of retired or separated participants receiving benefits | 2013-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-05-01 | 0 |
| Number of employers contributing to the scheme | 2013-05-01 | 0 |
| 2012: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 656 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 734 |
| Total of all active and inactive participants | 2012-05-01 | 734 |
| Total participants | 2012-05-01 | 0 |
| Number of retired or separated participants receiving benefits | 2012-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-05-01 | 0 |
| Number of employers contributing to the scheme | 2012-05-01 | 0 |
| 2011: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-05-01 | 583 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 656 |
| Total of all active and inactive participants | 2011-05-01 | 656 |
| Total participants | 2011-05-01 | 656 |
| Number of retired or separated participants receiving benefits | 2011-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-05-01 | 0 |
| Number of employers contributing to the scheme | 2011-05-01 | 0 |
| 2010: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-05-01 | 584 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 583 |
| Total of all active and inactive participants | 2010-05-01 | 583 |
| Total participants | 2010-05-01 | 583 |
| Number of retired or separated participants receiving benefits | 2010-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-05-01 | 0 |
| Number of employers contributing to the scheme | 2010-05-01 | 0 |
| 2009: SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-05-01 | 503 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 584 |
| Total of all active and inactive participants | 2009-05-01 | 584 |
| Total participants | 2009-05-01 | 584 |
| Number of retired or separated participants receiving benefits | 2009-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-05-01 | 0 |
| Number of employers contributing to the scheme | 2009-05-01 | 0 |
| Measure | Date | Value |
|---|
| 2020 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-04-30 | $73,708 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-04-30 | $73,944 |
| Total income from all sources (including contributions) | 2020-04-30 | $12,007,469 |
| Total of all expenses incurred | 2020-04-30 | $12,025,709 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-04-30 | $11,926,118 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-04-30 | $12,007,469 |
| Value of total assets at end of year | 2020-04-30 | $105,001 |
| Value of total assets at beginning of year | 2020-04-30 | $123,477 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-04-30 | $99,591 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-04-30 | No |
| Was this plan covered by a fidelity bond | 2020-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2020-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-04-30 | No |
| Contributions received from participants | 2020-04-30 | $2,438,962 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2020-04-30 | $21,589 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-04-30 | $600,822 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-04-30 | $73,708 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-04-30 | $73,944 |
| Total non interest bearing cash at end of year | 2020-04-30 | $189 |
| Total non interest bearing cash at beginning of year | 2020-04-30 | $18,429 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-04-30 | No |
| Value of net income/loss | 2020-04-30 | $-18,240 |
| Value of net assets at end of year (total assets less liabilities) | 2020-04-30 | $31,293 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-04-30 | $49,533 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-04-30 | No |
| Value of interest in pooled separate accounts at end of year | 2020-04-30 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-04-30 | $11,152,417 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-04-30 | No |
| Contributions received in cash from employer | 2020-04-30 | $9,546,918 |
| Employer contributions (assets) at end of year | 2020-04-30 | $104,812 |
| Employer contributions (assets) at beginning of year | 2020-04-30 | $105,048 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-04-30 | $172,879 |
| Contract administrator fees | 2020-04-30 | $99,591 |
| 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 | 2020-04-30 | No |
| Did the plan have assets held for investment | 2020-04-30 | No |
| 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 | 2020-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-04-30 | Unqualified |
| Accountancy firm name | 2020-04-30 | STACK AND ASSOCIATES, CPAS |
| Accountancy firm EIN | 2020-04-30 | 043595246 |
| 2019 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-04-30 | $73,944 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-04-30 | $111,065 |
| Total income from all sources (including contributions) | 2019-04-30 | $10,319,433 |
| Total of all expenses incurred | 2019-04-30 | $10,290,364 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-04-30 | $10,199,358 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-04-30 | $10,319,433 |
| Value of total assets at end of year | 2019-04-30 | $123,477 |
| Value of total assets at beginning of year | 2019-04-30 | $131,529 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-04-30 | $91,006 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-04-30 | No |
| Was this plan covered by a fidelity bond | 2019-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2019-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-04-30 | No |
| Contributions received from participants | 2019-04-30 | $2,138,072 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2019-04-30 | $47,758 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-04-30 | $608,103 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-04-30 | $73,944 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-04-30 | $111,065 |
| Total non interest bearing cash at end of year | 2019-04-30 | $18,429 |
| Total non interest bearing cash at beginning of year | 2019-04-30 | $18,615 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-04-30 | No |
| Value of net income/loss | 2019-04-30 | $29,069 |
| Value of net assets at end of year (total assets less liabilities) | 2019-04-30 | $49,533 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-04-30 | $20,464 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-04-30 | No |
| Value of interest in pooled separate accounts at end of year | 2019-04-30 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-04-30 | $9,420,117 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-04-30 | No |
| Contributions received in cash from employer | 2019-04-30 | $8,133,603 |
| Employer contributions (assets) at end of year | 2019-04-30 | $105,048 |
| Employer contributions (assets) at beginning of year | 2019-04-30 | $112,914 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-04-30 | $171,138 |
| Contract administrator fees | 2019-04-30 | $91,006 |
| 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 | 2019-04-30 | No |
| Did the plan have assets held for investment | 2019-04-30 | No |
| 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 | 2019-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-04-30 | Unqualified |
| Accountancy firm name | 2019-04-30 | STACK AND ASSOCIATES, CPAS |
| Accountancy firm EIN | 2019-04-30 | 043595246 |
| 2018 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-04-30 | $111,065 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-04-30 | $81,788 |
| Total income from all sources (including contributions) | 2018-04-30 | $9,373,392 |
| Total of all expenses incurred | 2018-04-30 | $9,371,432 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-04-30 | $9,291,045 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-04-30 | $9,373,392 |
| Value of total assets at end of year | 2018-04-30 | $131,529 |
| Value of total assets at beginning of year | 2018-04-30 | $100,292 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-04-30 | $80,387 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-04-30 | No |
| Was this plan covered by a fidelity bond | 2018-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2018-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-04-30 | No |
| Contributions received from participants | 2018-04-30 | $1,963,974 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2018-04-30 | $22,012 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-04-30 | $538,207 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-04-30 | $111,065 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-04-30 | $81,788 |
| Total non interest bearing cash at end of year | 2018-04-30 | $18,615 |
| Total non interest bearing cash at beginning of year | 2018-04-30 | $18,569 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-04-30 | No |
| Value of net income/loss | 2018-04-30 | $1,960 |
| Value of net assets at end of year (total assets less liabilities) | 2018-04-30 | $20,464 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-04-30 | $18,504 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-04-30 | No |
| Value of interest in common/collective trusts at end of year | 2018-04-30 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-04-30 | $8,576,680 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-04-30 | No |
| Contributions received in cash from employer | 2018-04-30 | $7,387,406 |
| Employer contributions (assets) at end of year | 2018-04-30 | $112,914 |
| Employer contributions (assets) at beginning of year | 2018-04-30 | $81,723 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-04-30 | $176,158 |
| Contract administrator fees | 2018-04-30 | $80,387 |
| 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 | 2018-04-30 | No |
| Did the plan have assets held for investment | 2018-04-30 | No |
| 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 | 2018-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-04-30 | Unqualified |
| Accountancy firm name | 2018-04-30 | STACK AND ASSOCIATES, CPAS |
| Accountancy firm EIN | 2018-04-30 | 043595246 |
| 2017 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-04-30 | $81,788 |
| Total plan liabilities at beginning of year | 2017-04-30 | $23,435 |
| Total income from all sources | 2017-04-30 | $8,084,268 |
| Expenses. Total of all expenses incurred | 2017-04-30 | $8,084,269 |
| Benefits paid (including direct rollovers) | 2017-04-30 | $7,997,317 |
| Total plan assets at end of year | 2017-04-30 | $100,292 |
| Total plan assets at beginning of year | 2017-04-30 | $41,940 |
| Total contributions received or receivable from participants | 2017-04-30 | $1,823,446 |
| Expenses. Other expenses not covered elsewhere | 2017-04-30 | $86,952 |
| Contributions received from other sources (not participants or employers) | 2017-04-30 | $15,427 |
| Net income (gross income less expenses) | 2017-04-30 | $-1 |
| Net plan assets at end of year (total assets less liabilities) | 2017-04-30 | $18,504 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-04-30 | $18,505 |
| Total contributions received or receivable from employer(s) | 2017-04-30 | $6,245,395 |
| 2016 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-04-30 | $23,435 |
| Total plan liabilities at beginning of year | 2016-04-30 | $55,493 |
| Total income from all sources | 2016-04-30 | $7,072,821 |
| Expenses. Total of all expenses incurred | 2016-04-30 | $7,086,114 |
| Benefits paid (including direct rollovers) | 2016-04-30 | $7,000,385 |
| Total plan assets at end of year | 2016-04-30 | $41,940 |
| Total plan assets at beginning of year | 2016-04-30 | $87,291 |
| Total contributions received or receivable from participants | 2016-04-30 | $1,550,811 |
| Expenses. Other expenses not covered elsewhere | 2016-04-30 | $85,729 |
| Contributions received from other sources (not participants or employers) | 2016-04-30 | $7,174 |
| Net income (gross income less expenses) | 2016-04-30 | $-13,293 |
| Net plan assets at end of year (total assets less liabilities) | 2016-04-30 | $18,505 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-04-30 | $31,798 |
| Total contributions received or receivable from employer(s) | 2016-04-30 | $5,514,836 |
| 2015 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-04-30 | $55,493 |
| Total plan liabilities at beginning of year | 2015-04-30 | $23,619 |
| Total income from all sources | 2015-04-30 | $6,341,492 |
| Expenses. Total of all expenses incurred | 2015-04-30 | $6,355,050 |
| Benefits paid (including direct rollovers) | 2015-04-30 | $6,261,887 |
| Total plan assets at end of year | 2015-04-30 | $87,291 |
| Total plan assets at beginning of year | 2015-04-30 | $68,975 |
| Total contributions received or receivable from participants | 2015-04-30 | $1,386,860 |
| Expenses. Other expenses not covered elsewhere | 2015-04-30 | $93,163 |
| Contributions received from other sources (not participants or employers) | 2015-04-30 | $15,141 |
| Net income (gross income less expenses) | 2015-04-30 | $-13,558 |
| Net plan assets at end of year (total assets less liabilities) | 2015-04-30 | $31,798 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-04-30 | $45,356 |
| Total contributions received or receivable from employer(s) | 2015-04-30 | $4,939,491 |
| 2014 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-04-30 | $23,619 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-04-30 | $17,434 |
| Total income from all sources (including contributions) | 2014-04-30 | $5,597,683 |
| Total of all expenses incurred | 2014-04-30 | $5,590,196 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-04-30 | $5,492,754 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-04-30 | $5,597,683 |
| Value of total assets at end of year | 2014-04-30 | $68,975 |
| Value of total assets at beginning of year | 2014-04-30 | $55,303 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-04-30 | $97,442 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-04-30 | No |
| Was this plan covered by a fidelity bond | 2014-04-30 | No |
| If this is an individual account plan, was there a blackout period | 2014-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-04-30 | No |
| Contributions received from participants | 2014-04-30 | $1,280,106 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2014-04-30 | $30,763 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-04-30 | $646,631 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-04-30 | $23,619 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-04-30 | $17,434 |
| Total non interest bearing cash at end of year | 2014-04-30 | $18,473 |
| Total non interest bearing cash at beginning of year | 2014-04-30 | $9,773 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-04-30 | No |
| Value of net income/loss | 2014-04-30 | $7,487 |
| Value of net assets at end of year (total assets less liabilities) | 2014-04-30 | $45,356 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-04-30 | $37,869 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-04-30 | No |
| Value of interest in common/collective trusts at end of year | 2014-04-30 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-04-30 | $4,733,689 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-04-30 | No |
| Contributions received in cash from employer | 2014-04-30 | $4,286,814 |
| Employer contributions (assets) at end of year | 2014-04-30 | $50,502 |
| Employer contributions (assets) at beginning of year | 2014-04-30 | $45,530 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-04-30 | $112,434 |
| Contract administrator fees | 2014-04-30 | $97,442 |
| Did the plan have assets held for investment | 2014-04-30 | No |
| 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 | 2014-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-04-30 | Unqualified |
| Accountancy firm name | 2014-04-30 | STACK AND ASSOCIATES, CPAS |
| Accountancy firm EIN | 2014-04-30 | 043595246 |
| 2013 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-04-30 | $17,434 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-04-30 | $16,649 |
| Total income from all sources (including contributions) | 2013-04-30 | $5,062,166 |
| Total of all expenses incurred | 2013-04-30 | $5,035,507 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-04-30 | $4,944,854 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-04-30 | $5,062,166 |
| Value of total assets at end of year | 2013-04-30 | $55,303 |
| Value of total assets at beginning of year | 2013-04-30 | $27,859 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-04-30 | $90,653 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-04-30 | No |
| Was this plan covered by a fidelity bond | 2013-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-04-30 | No |
| Contributions received from participants | 2013-04-30 | $1,141,641 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2013-04-30 | $31,525 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-04-30 | $535,025 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-04-30 | $17,434 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-04-30 | $16,649 |
| Total non interest bearing cash at end of year | 2013-04-30 | $9,773 |
| Total non interest bearing cash at beginning of year | 2013-04-30 | $1,310 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-04-30 | No |
| Value of net income/loss | 2013-04-30 | $26,659 |
| Value of net assets at end of year (total assets less liabilities) | 2013-04-30 | $37,869 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-04-30 | $11,210 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-04-30 | No |
| Value of interest in common/collective trusts at end of year | 2013-04-30 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-04-30 | $4,315,579 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-04-30 | No |
| Contributions received in cash from employer | 2013-04-30 | $3,889,000 |
| Employer contributions (assets) at end of year | 2013-04-30 | $45,530 |
| Employer contributions (assets) at beginning of year | 2013-04-30 | $26,549 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-04-30 | $94,250 |
| Contract administrator fees | 2013-04-30 | $90,653 |
| Did the plan have assets held for investment | 2013-04-30 | No |
| 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 | 2013-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-04-30 | Unqualified |
| Accountancy firm name | 2013-04-30 | STACK AND ASSOCIATES, CPAS |
| Accountancy firm EIN | 2013-04-30 | 043595246 |
| 2012 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2012 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-04-30 | $16,649 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-04-30 | $13,545 |
| Total income from all sources (including contributions) | 2012-04-30 | $4,335,299 |
| Total of all expenses incurred | 2012-04-30 | $4,351,979 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-04-30 | $4,270,774 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-04-30 | $4,335,299 |
| Value of total assets at end of year | 2012-04-30 | $27,859 |
| Value of total assets at beginning of year | 2012-04-30 | $41,435 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-04-30 | $81,205 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-04-30 | No |
| Was this plan covered by a fidelity bond | 2012-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-04-30 | No |
| Contributions received from participants | 2012-04-30 | $1,005,703 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-04-30 | $10,239 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-04-30 | $502,748 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-04-30 | $16,649 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-04-30 | $13,545 |
| Total non interest bearing cash at end of year | 2012-04-30 | $1,310 |
| Total non interest bearing cash at beginning of year | 2012-04-30 | $3,236 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-04-30 | No |
| Value of net income/loss | 2012-04-30 | $-16,680 |
| Value of net assets at end of year (total assets less liabilities) | 2012-04-30 | $11,210 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-04-30 | $27,890 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-04-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-04-30 | $3,696,333 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-04-30 | No |
| Contributions received in cash from employer | 2012-04-30 | $3,319,357 |
| Employer contributions (assets) at end of year | 2012-04-30 | $26,549 |
| Employer contributions (assets) at beginning of year | 2012-04-30 | $38,199 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-04-30 | $71,693 |
| Contract administrator fees | 2012-04-30 | $81,205 |
| Did the plan have assets held for investment | 2012-04-30 | No |
| 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 | 2012-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-04-30 | Unqualified |
| Accountancy firm name | 2012-04-30 | STACK AND ASSOCIATES, CPAS |
| Accountancy firm EIN | 2012-04-30 | 043595246 |
| 2011 : SAN YSIDRO HEALTH EMPLOYEE WELFARE BENEFIT PLAN 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-04-30 | $13,545 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-04-30 | $10,721 |
| Total income from all sources (including contributions) | 2011-04-30 | $3,705,639 |
| Total of all expenses incurred | 2011-04-30 | $3,684,484 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-04-30 | $3,588,038 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-04-30 | $3,705,639 |
| Value of total assets at end of year | 2011-04-30 | $41,435 |
| Value of total assets at beginning of year | 2011-04-30 | $17,456 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-04-30 | $96,446 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-04-30 | No |
| Was this plan covered by a fidelity bond | 2011-04-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-04-30 | No |
| Contributions received from participants | 2011-04-30 | $957,764 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2011-04-30 | $25,488 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-04-30 | $462,231 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-04-30 | $13,545 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-04-30 | $10,721 |
| Administrative expenses (other) incurred | 2011-04-30 | $9,954 |
| Total non interest bearing cash at end of year | 2011-04-30 | $3,236 |
| Total non interest bearing cash at beginning of year | 2011-04-30 | $6,735 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-04-30 | No |
| Value of net income/loss | 2011-04-30 | $21,155 |
| Value of net assets at end of year (total assets less liabilities) | 2011-04-30 | $27,890 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-04-30 | $6,735 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-04-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-04-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-04-30 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-04-30 | $3,035,237 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-04-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-04-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-04-30 | No |
| Contributions received in cash from employer | 2011-04-30 | $2,722,387 |
| Employer contributions (assets) at end of year | 2011-04-30 | $38,199 |
| Employer contributions (assets) at beginning of year | 2011-04-30 | $10,721 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-04-30 | $90,570 |
| Contract administrator fees | 2011-04-30 | $86,492 |
| Did the plan have assets held for investment | 2011-04-30 | No |
| 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 | 2011-04-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-04-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-04-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-04-30 | Unqualified |
| Accountancy firm name | 2011-04-30 | STACK AND ASSOCIATES, CPAS |
| Accountancy firm EIN | 2011-04-30 | 043595246 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 2 |
| Insurance contract or identification number | E3200706 | | Number of Individuals Covered | 395 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2024-04-30 | | Total amount of commissions paid to insurance broker | USD $56,085 | | Total amount of fees paid to insurance company | USD $3,371 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $558,571 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SHARP HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 90611 ) |
| Policy contract number | 1001876 |
| Policy instance | 1 |
| Insurance contract or identification number | 1001876 | | Number of Individuals Covered | 3194 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2024-04-30 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,776,783 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 324 |
| Policy instance | 8 |
| Insurance contract or identification number | 324 | | Number of Individuals Covered | 1492 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2024-04-30 | | Total amount of commissions paid to insurance broker | USD $71,598 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,388,543 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 3 |
| Insurance contract or identification number | 102507 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2024-04-30 | | Total amount of commissions paid to insurance broker | USD $1,089 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LEGAL | | Welfare Benefit Premiums Paid to Carrier | USD $8,521 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10000831001 |
| Policy instance | 4 |
| Insurance contract or identification number | 10000831001 | | Number of Individuals Covered | 4054 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2024-04-30 | | Total amount of commissions paid to insurance broker | USD $28,536 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $308,596 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LANDMARK HEALTHPLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NS0025-000 |
| Policy instance | 5 |
| Insurance contract or identification number | NS0025-000 | | Number of Individuals Covered | 1730 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2024-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CHIROPRACTIC/ACUPUNTURE | | Welfare Benefit Premiums Paid to Carrier | USD $49,862 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH AND HUMAN RESOURCES CENTER, INC. (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 1541069 |
| Policy instance | 6 |
| Insurance contract or identification number | 1541069 | | Number of Individuals Covered | 2607 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2024-04-30 | | Total amount of commissions paid to insurance broker | USD $5,115 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $51,150 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL159226 |
| Policy instance | 7 |
| Insurance contract or identification number | GL159226 | | Number of Individuals Covered | 2386 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2024-04-30 | | Total amount of commissions paid to insurance broker | USD $65,809 | | Total amount of fees paid to insurance company | USD $12,489 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $822,607 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SHARP HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 90611 ) |
| Policy contract number | 1001876 |
| Policy instance | 1 |
| Insurance contract or identification number | 1001876 | | Number of Individuals Covered | 2575 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,346,742 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 324 |
| Policy instance | 2 |
| Insurance contract or identification number | 324 | | Number of Individuals Covered | 1272 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $64,867 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,162,224 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 3 |
| Insurance contract or identification number | E3200706 | | Number of Individuals Covered | 384 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $44,314 | | Total amount of fees paid to insurance company | USD $1,097 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $477,258 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 4 |
| Insurance contract or identification number | 102507 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $1,217 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LEGAL | | Welfare Benefit Premiums Paid to Carrier | USD $6,982 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10000831001 |
| Policy instance | 5 |
| Insurance contract or identification number | 10000831001 | | Number of Individuals Covered | 3444 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $22,170 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $189,895 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LANDMARK HEALTHPLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NS0025-000 |
| Policy instance | 6 |
| Insurance contract or identification number | NS0025-000 | | Number of Individuals Covered | 1676 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CHIROPRACTIC/ACUPUNTURE | | Welfare Benefit Premiums Paid to Carrier | USD $47,940 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL159226 |
| Policy instance | 8 |
| Insurance contract or identification number | GL159226 | | Number of Individuals Covered | 2115 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $56,506 | | Total amount of fees paid to insurance company | USD $9,170 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $706,327 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH AND HUMAN RESOURCES CENTER, INC. (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 1541069 |
| Policy instance | 7 |
| Insurance contract or identification number | 1541069 | | Number of Individuals Covered | 2501 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $4,246 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $38,786 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SHARP HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 90611 ) |
| Policy contract number | 1001876 |
| Policy instance | 1 |
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 324 |
| Policy instance | 2 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 3 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 4 |
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NS0025-000 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL159226 |
| Policy instance | 7 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10000831001 |
| Policy instance | 5 |
| SHARP HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 90611 ) |
| Policy contract number | 1001876 |
| Policy instance | 1 |
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 324 |
| Policy instance | 2 |
| COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3200706 |
| Policy instance | 3 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 4 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10000831001 |
| Policy instance | 5 |
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NS0025-000 |
| Policy instance | 6 |
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | SYHC |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL159226 |
| Policy instance | 8 |
| SHARP HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 90611 ) |
| Policy contract number | 1001876 |
| Policy instance | 1 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10000831001 |
| Policy instance | 9 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 9324 |
| Policy instance | 8 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 7 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 129904 |
| Policy instance | 5 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 1 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 2 |
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 0009136625-B |
| Policy instance | 3 |
| LANDMARK HEALTHPLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NS0025*000 |
| Policy instance | 10 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 159226 |
| Policy instance | 4 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 4 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 8 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 9324 |
| Policy instance | 7 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL159226 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD129904 |
| Policy instance | 5 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 6 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 2 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 4 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10000831001 |
| Policy instance | 9 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 8 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 9324 |
| Policy instance | 7 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 1 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 2 |
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 0009136625-B |
| Policy instance | 3 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 4 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 5 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 6 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 7 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 9324 |
| Policy instance | 8 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 2 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 7008385 |
| Policy instance | 3 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 4 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 5 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 6 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 9324 |
| Policy instance | 7 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 8 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 1000083 |
| Policy instance | 9 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 8 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 9324 |
| Policy instance | 7 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 2 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 1 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 2 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 7008385 |
| Policy instance | 3 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 4 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 6 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 7 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 5 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 9324 |
| Policy instance | 8 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 1000083 |
| Policy instance | 9 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 9324 |
| Policy instance | 7 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 6 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 5 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 7008385 |
| Policy instance | 3 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 4 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 2 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 2 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 4 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 6 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 1 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 3 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 7008385 |
| Policy instance | 4 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 5 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 9324 |
| Policy instance | 8 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 7 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 2 |
| SIMNSA (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 9324 |
| Policy instance | 8 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 7 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 5 |
| SIMNSA (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 324 |
| Policy instance | 3 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 6 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 1 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 2 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 102507 |
| Policy instance | 5 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 6 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 7 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 2 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 649688 |
| Policy instance | 3 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 7008385 |
| Policy instance | 4 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 5 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 7 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 7008385 |
| Policy instance | 5 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 4 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 3 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 2 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 7008385 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 091336 |
| Policy instance | 4 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 3 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 091336 |
| Policy instance | 2 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 091336 |
| Policy instance | 3 |
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 62149 ) |
| Policy contract number | 324 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 3 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 091336 |
| Policy instance | 2 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 228316 |
| Policy instance | 3 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 091336 |
| Policy instance | 2 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E3200706 |
| Policy instance | 1 |
