Civic Intelligence
Filing

Hbma Ee Health and Welfare Plan

Hanson Building Materials America • EIN 22-3473702 • Plan year 2000

Company ProfileSource Archive
Filing Insights

Participants

Up

13,794 → 15,454

1,660 • 12.03%

Assets

No comparison

- → -

No earlier value available.

Investment Management Fee

-

Admin expenses - • Total expenses -

Filing Details

Context

No event flags were generated for this filing.

Status Flags

Fidelity bond in place

Not reported

Limited-scope audit performed

Not reported

Contributions transmitted on time

Not reported

Participant loans in default

Not reported

Leases in default

Not reported

Reportable party-in-interest issues

Not reported

Loss discovered during year

Not reported

Assets with undetermined value

Not reported

Non-cash contributions

Not reported

Assets held for investment

Not reported

5% transactions reported

Not reported

All plan assets distributed

Not reported

Benefits paid when due

Not reported

Plan blackout period

Not reported

Plan termination resolution adopted

Not reported

Counterparties

Company Timeline

This filing is highlighted inside the broader sponsor history.

Year / FilingFilingsParticipantsAssetsContributionsContrib./Participant
2002710,586$927,403,138$19,363,754$1,829iApproximate average salary by contribution assumption: employee only about $45,730 at 4% or $30,486 at 6%; with 50% employer match about $30,486 at 4% or $20,324 at 6%; with 100% employer match about $22,865 at 4% or $15,243 at 6%.
Defined Benefit Master Trust-7,974$715,091,968--
HANSON BUILDING MATERIALS AMERICA RETIREMENT SAVINGS & INVESTMENT PLAN-10,586$203,467,772$18,907,263$1,786iApproximate average salary by contribution assumption: employee only about $44,652 at 4% or $29,768 at 6%; with 50% employer match about $29,768 at 4% or $19,845 at 6%; with 100% employer match about $22,326 at 4% or $14,884 at 6%.
HBMA UNION, NE REGION-166$5,941,550--
HANSON BUILDING MATERIALS AMERICA RETIREMENT SAVINGS & INVESTMENT PLAN FOR COLLECTIVELY BARGAINED EMPLOYEES-373$2,901,848$384,870$1,032iApproximate average salary by contribution assumption: employee only about $25,796 at 4% or $17,197 at 6%; with 50% employer match about $17,197 at 4% or $11,465 at 6%; with 100% employer match about $12,898 at 4% or $8,599 at 6%.
BASIC CONSTRUCTION MATERIALS HOURLY 401K PLAN-0-$21,502-
HIGHLAND/PLUM RUN CONSTRUCTION HOURLY 401K PLAN-0-$50,119-
Hbma Ee Health and Welfare Plan-10,332---
2001711,779$234,126,824$21,022,027$1,785iApproximate average salary by contribution assumption: employee only about $44,618 at 4% or $29,745 at 6%; with 50% employer match about $29,745 at 4% or $19,830 at 6%; with 100% employer match about $22,309 at 4% or $14,873 at 6%.
HANSON BUILDING MATERIALS AMERIC RETIREMENT SAVINGS & INVESTMENT PLAN-5,214$225,065,761$20,591,299$3,949iApproximate average salary by contribution assumption: employee only about $98,731 at 4% or $65,821 at 6%; with 50% employer match about $65,821 at 4% or $43,880 at 6%; with 100% employer match about $49,365 at 4% or $32,910 at 6%.
Hbma Union, Mw & Se Regions-68$7,093,061$150,000$2,206iApproximate average salary by contribution assumption: employee only about $55,147 at 4% or $36,765 at 6%; with 50% employer match about $36,765 at 4% or $24,510 at 6%; with 100% employer match about $27,574 at 4% or $18,382 at 6%.
RETIREMENT SAVINGS & INVESTMENT PLAN - COLLECTIVEL BARGAINING-221$1,968,002$280,728$1,270iApproximate average salary by contribution assumption: employee only about $31,757 at 4% or $21,171 at 6%; with 50% employer match about $21,171 at 4% or $14,114 at 6%; with 100% employer match about $15,878 at 4% or $10,586 at 6%.
HIGHLAND/PLUM RUN CONSTRUCTION HOURLY 401K PLAN-93---
BASIC CONSTRUCTION MATERIALS HOURLY 401K PLAN-64---
Hbma Ee Health and Welfare Plan-11,779---
HBMA UNION, NE REGION-166---
2000515,454$2,396,605$0-
Hbma Union, Mw & Se Regions-72$2,396,605--
Hbma Ee Health and Welfare PlanCurrent15,454---
HANSON BUILDING MATERIALS AMERIC RETIREMENT SAVINGS & INVESTMENT PLAN-4,499---
Defined Benefit Master Trust-4,859---
HBMA UNION, NE REGION-168---
1999513,794$855,639,805$1,343,035$97iApproximate average salary by contribution assumption: employee only about $2,434 at 4% or $1,623 at 6%; with 50% employer match about $1,623 at 4% or $1,082 at 6%; with 100% employer match about $1,217 at 4% or $811 at 6%.
Defined Benefit Master Trust-4,896$848,657,763$902,967$184iApproximate average salary by contribution assumption: employee only about $4,611 at 4% or $3,074 at 6%; with 50% employer match about $3,074 at 4% or $2,049 at 6%; with 100% employer match about $2,305 at 4% or $1,537 at 6%.
Hanson B M a Corporate Retirement Savings and Investment Plan-35$4,403,035$440,068$12,573iApproximate average salary by contribution assumption: employee only about $314,334 at 4% or $209,556 at 6%; with 50% employer match about $209,556 at 4% or $139,704 at 6%; with 100% employer match about $157,167 at 4% or $104,778 at 6%.
Hbma Union, Mw & Se Regions-109$2,579,007--
Hbma Ee Health and Welfare Plan-13,794---
Defined Benefit Master Trust-4,925---
Schedule Details

Schedule A

Row 1
Filing Id
84037163417052
Form Id
16652695
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050017
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 2
Filing Id
84037163417052
Form Id
16652680
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050002
Ins Broker 01 Name
WILLIAM L ALTMAN
Ins Broker 01 Street Addr
ALTMAN INS CPO BOX 3125
Ins Broker 01 City
LOUISVILLE
Ins Broker 01 State
KY
Ins Broker 01 ZIP Code
40201
Ins Broker Comm Pd 01 Amount
$6,104
Ins Broker Fees Pd 01 Amount
$0
Row 3
Filing Id
84037163417052
Form Id
16652681
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050003
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 4
Filing Id
84037163417052
Form Id
16652682
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050004
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 5
Filing Id
84037163417052
Form Id
16652684
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050006
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 6
Filing Id
84037163417052
Form Id
16652685
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050007
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 7
Filing Id
84037163417052
Form Id
16652686
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050008
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 8
Filing Id
84037163417052
Form Id
16652687
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050009
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 9
Filing Id
84037163417052
Form Id
16652688
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050010
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 10
Filing Id
84037163417052
Form Id
16652690
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050012
Ins Broker Comm Pd 01 Amount
$1,269
Ins Broker Fees Pd 01 Amount
$0
Row 11
Filing Id
84037163417052
Form Id
16652691
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050013
Ins Broker 01 Name
WILLIS TEXAS
Ins Broker 01 Street Addr
9300 LBJ FREEWAY, STE 1300
Ins Broker 01 City
DALLAS
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
75243
Ins Broker Comm Pd 01 Amount
$30,935
Ins Broker Fees Pd 01 Amount
$0
Row 12
Filing Id
84037163417052
Form Id
16652692
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050014
Ins Broker 01 Name
JAMES F OLD, ONE METRO PLACE
Ins Broker 01 Street Addr
545 METRO PLACE SOUTH, STE 100
Ins Broker 01 City
DUBLIN
Ins Broker 01 State
OH
Ins Broker 01 ZIP Code
43017
Ins Broker Comm Pd 01 Amount
$205
Ins Broker Fees Pd 01 Amount
$0
Row 13
Filing Id
84037163417052
Form Id
16652693
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050015
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 14
Filing Id
84037163417052
Form Id
16652694
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050016
Ins Broker 01 Name
WILLIS CORROON LIFE INS
Ins Broker Comm Pd 01 Amount
$22,299
Ins Broker Fees Pd 01 Amount
$0
Row 15
Filing Id
84037163417052
Form Id
16652696
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050018
Ins Broker 01 Name
WILLIS CORROON LIFE INS
Ins Broker 01 Street Addr
P O BOX 73075
Ins Broker 01 City
DALLAS
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
75373
Ins Broker Comm Pd 01 Amount
$93,963
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 16
Filing Id
84037163417052
Form Id
16652697
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050019
Ins Broker 01 Name
WILLIS CORROON LIFE
Ins Broker 01 Street Addr
PO BOX 730175
Ins Broker 01 City
DALLAS
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
75373
Ins Broker Comm Pd 01 Amount
$28,130
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 17
Filing Id
84037163417052
Form Id
16652699
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050021
Ins Broker 01 Name
WILLIS OF TEXAS
Ins Broker 01 Street Addr
301 COMMERCE AVE
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
76102
Ins Broker Comm Pd 01 Amount
$31,723
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 18
Filing Id
84037163417052
Form Id
16652700
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050022
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 19
Filing Id
84037163417052
Form Id
16652698
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050020
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 20
Filing Id
84037163417052
Form Id
16652683
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050005
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 21
Filing Id
84037163417052
Form Id
16652689
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
10372163417050011
Ins Broker Comm Pd 01 Amount
$3,794
Ins Broker Fees Pd 01 Amount
$0
Row 22
Ins Carrier Name: ZURICH AMERICAN INS CO
Filing Id
84037163417052
Form Id
16652698
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
ZURICH AMERICAN INS CO
Ins Contract Num
1815648
Ins Policy From Date
1999-07-01
Ins Policy To Date
2000-06-30
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
M
Wlfr Type Bnft Oth Text
NY DISABILITY
Wlfr Premium Rcvd Amount
$40,097
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$40,097
Wlfr Claims Paid Amount
$45,449
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$45,449
Wlfr Claims Chrgd Amount
$45,449
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$2,847
Wlfr Ret Taxes Amount
$1,083
Wlfr Ret Charges Amount
$1,363
Wlfr Ret Oth Chrgs Amount
$601
Wlfr Ret Total Amount
$5,894
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$0
Wlfr Acquis Cost Amount
$0
Row 23
Ins Carrier Name: RELIASTAR LIFE INS CO
Filing Id
84037163417052
Form Id
16652699
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
RELIASTAR LIFE INS CO
Ins Carrier EIN
41-0451140
Ins Carrier Naic Code
67105
Ins Contract Num
57051
Ins Prsn Covered End of year Count
18,792
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$31,723
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
C
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$587,408
Wlfr Acquis Cost Amount
$0
Row 24
Ins Carrier Name: CAREFIRST OF MARYLAND INC
Filing Id
84037163417052
Form Id
16652700
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
CAREFIRST OF MARYLAND INC
Ins Carrier EIN
52-1385894
Ins Carrier Naic Code
47058
Ins Contract Num
08099
Ins Prsn Covered End of year Count
697
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$1,039,665
Wlfr Acquis Cost Amount
$0
Row 25
Ins Carrier Name: FORTIS BENEFITS INS CO
Filing Id
84037163417052
Form Id
16652680
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
FORTIS BENEFITS INS CO
Ins Carrier EIN
81-0170040
Ins Carrier Naic Code
70408
Ins Contract Num
G#60627
Ins Prsn Covered End of year Count
366
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$6,104
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
DEFM
Wlfr Type Bnft Oth Text
AD&D
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$40,103
Wlfr Acquis Cost Amount
$0
Row 26
Ins Carrier Name: AETNA INSURANCE
Filing Id
84037163417052
Form Id
16652681
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
AETNA INSURANCE
Ins Carrier EIN
06-6033492
Ins Carrier Naic Code
60054
Ins Contract Num
013683-ERG
Ins Prsn Covered End of year Count
110
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
DEFM
Wlfr Type Bnft Oth Text
AD&D
Wlfr Premium Rcvd Amount
$201,328
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$201,328
Wlfr Claims Paid Amount
$14,000
Wlfr Incr Reserve Amount
$-4,944
Wlfr Incurred Claim Amount
$9,056
Wlfr Claims Chrgd Amount
$43,262
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$155,097
Wlfr Ret Taxes Amount
$3,998
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$-1,544
Wlfr Ret Total Amount
$157,551
Wlfr Refund Indicator
Yes
Wlfr Refund Amount
$515
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$0
Wlfr Acquis Cost Amount
$0
Row 27
Ins Carrier Name: BCBSM, INC
Filing Id
84037163417052
Form Id
16652682
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
BCBSM, INC
Ins Carrier EIN
41-0984460
Ins Carrier Naic Code
55026
Ins Contract Num
CS460
Ins Prsn Covered End of year Count
562
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$81,156
Wlfr Acquis Cost Amount
$0
Row 28
Ins Carrier Name: HMO-KAISER PERMANENTE
Filing Id
84037163417052
Form Id
16652683
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
HMO-KAISER PERMANENTE
Ins Carrier EIN
94-1340523
Ins Contract Num
35-0000
Ins Prsn Covered End of year Count
396
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$695,623
Wlfr Acquis Cost Amount
$0
Row 29
Ins Carrier Name: KAISER FOUNDATION HEALTH PLAN
Filing Id
84037163417052
Form Id
16652684
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
KAISER FOUNDATION HEALTH PLAN
Ins Carrier EIN
94-1340523
Ins Contract Num
35-0002
Ins Prsn Covered End of year Count
153
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$95,819
Wlfr Acquis Cost Amount
$0
Row 30
Ins Carrier Name: HANSON PERMANENTE/COBRA
Filing Id
84037163417052
Form Id
16652685
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
HANSON PERMANENTE/COBRA
Ins Carrier EIN
94-1340523
Ins Contract Num
35-7000
Ins Prsn Covered End of year Count
3
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$1,990
Wlfr Acquis Cost Amount
$0
Row 31
Ins Carrier Name: HANSON AGG WEST - RETIREES
Filing Id
84037163417052
Form Id
16652686
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
HANSON AGG WEST - RETIREES
Ins Carrier EIN
94-1340523
Ins Contract Num
8217-0060
Ins Prsn Covered End of year Count
75
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$153,741
Wlfr Acquis Cost Amount
$0
Row 32
Ins Carrier Name: HANSON AGG EST GYPSUM RETIREES
Filing Id
84037163417052
Form Id
16652687
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
HANSON AGG EST GYPSUM RETIREES
Ins Carrier EIN
94-1340523
Ins Contract Num
8217-0070
Ins Prsn Covered End of year Count
11
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$17,014
Wlfr Acquis Cost Amount
$0
Row 33
Ins Carrier Name: HANSON AGG WEST RETIRED
Filing Id
84037163417052
Form Id
16652688
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
HANSON AGG WEST RETIRED
Ins Carrier EIN
94-1340523
Ins Contract Num
8217-0080
Ins Prsn Covered End of year Count
102
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$204,347
Wlfr Acquis Cost Amount
$0
Row 34
Ins Carrier Name: LINCOLN NATIONA LIFE INSURANCE
Filing Id
84037163417052
Form Id
16652689
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
LINCOLN NATIONA LIFE INSURANCE
Ins Contract Num
GP48465
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$3,794
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
D
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$126,480
Wlfr Acquis Cost Amount
$0
Row 35
Ins Carrier Name: HEALTHNET
Filing Id
84037163417052
Form Id
16652690
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
HEALTHNET
Ins Carrier EIN
95-4402957
Ins Contract Num
57694S,A,B,N
Ins Prsn Covered End of year Count
13
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$1,269
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$36,354
Wlfr Acquis Cost Amount
$0
Row 36
Ins Carrier Name: ZURICH
Filing Id
84037163417052
Form Id
16652691
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
ZURICH
Ins Carrier EIN
36-4233459
Ins Carrier Naic Code
16535
Ins Contract Num
GTU3586807
Ins Prsn Covered End of year Count
5,312
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$30,935
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
M
Wlfr Type Bnft Oth Text
AD&D
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$309,349
Wlfr Acquis Cost Amount
$0
Row 37
Ins Carrier Name: COMPDENT
Filing Id
84037163417052
Form Id
16652692
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
COMPDENT
Ins Carrier EIN
35-1442318
Ins Carrier Naic Code
96599
Ins Contract Num
682310(G)
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$205
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
B
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$1,159
Wlfr Acquis Cost Amount
$0
Row 38
Ins Carrier Name: HIGHMARK BLUE CROSS BLUE SHIELD
Filing Id
84037163417052
Form Id
16652693
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
HIGHMARK BLUE CROSS BLUE SHIELD
Ins Carrier EIN
25-1522457
Ins Carrier Naic Code
54771
Ins Contract Num
46267
Ins Prsn Covered End of year Count
1,435
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$1,629,718
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$1,629,718
Wlfr Claims Paid Amount
$1,431,625
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$1,431,625
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$198,092
Wlfr Ret Total Amount
$198,092
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$0
Wlfr Acquis Cost Amount
$0
Row 39
Ins Carrier Name: CONNECTICUT GENERAL LIFE INS
Filing Id
84037163417052
Form Id
16652694
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
CONNECTICUT GENERAL LIFE INS
Ins Carrier EIN
06-0303370
Ins Carrier Naic Code
62308
Ins Contract Num
2373970
Ins Prsn Covered End of year Count
4,482
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$22,299
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
B
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$599,487
Wlfr Acquis Cost Amount
$156,989
Wlfr Acquis Cost Text
ASO SERVICE FEES PAID BY CUSTOMER TO CONN GENL LIFE I NSURANCE CO
Row 40
Ins Carrier Name: UNITED HEALTHCARE
Filing Id
84037163417052
Form Id
16652695
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
UNITED HEALTHCARE
Ins Contract Num
209405
Ins Prsn Covered End of year Count
25,505
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
AI
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$342,870
Wlfr Acquis Cost Amount
$0
Row 41
Ins Carrier Name: PROVIDENT LIFE INS
Filing Id
84037163417052
Form Id
16652696
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
PROVIDENT LIFE INS
Ins Carrier EIN
62-0331200
Ins Carrier Naic Code
68195
Ins Contract Num
123653
Ins Prsn Covered End of year Count
12,805
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$93,963
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
DFM
Wlfr Type Bnft Oth Text
AD&D
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$3,132,107
Wlfr Acquis Cost Amount
$0
Row 42
Ins Carrier Name: PROVIDENT LIFE & ACCIDENT INS CO
Filing Id
84037163417052
Form Id
16652697
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
PROVIDENT LIFE & ACCIDENT INS CO
Ins Carrier EIN
62-0331200
Ins Carrier Naic Code
68195
Ins Contract Num
123235
Ins Prsn Covered End of year Count
2,255
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$28,130
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
E
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$281,302
Wlfr Acquis Cost Amount
$0
Hbma Ee Health and Welfare Plan | Hanson Building Materials America | Plan 524 | 2000 Form 5500 Filing