Civic Intelligence
Filing

Hbma Ee Health and Welfare Plan

Hanson Building Materials America • EIN 22-3473702 • Plan year 2002

Company ProfileSource Archive
Filing Insights

Participants

Down

15,439 → 10,332

-5,107 • -33.08%

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 PlanCurrent10,332---
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 Plan-15,454---
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
84037343006793
Form Id
42716090
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040019
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 2
Filing Id
84037343006793
Form Id
42716073
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040002
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 3
Filing Id
84037343006793
Form Id
42716074
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040003
Ins Broker 01 Name
WILLIS CORROON LIFE
Ins Broker 01 Street Addr
301 COMMERCE ST STE 3050
Ins Broker 01 City
FT WORTH
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
76102
Ins Broker Comm Pd 01 Amount
$59,449
Ins Broker Fees Pd 01 Amount
$0
Row 4
Filing Id
84037343006793
Form Id
42716075
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040004
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
$45,562
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 5
Filing Id
84037343006793
Form Id
42716083
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040012
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 6
Filing Id
84037343006793
Form Id
42716076
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040005
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 7
Filing Id
84037343006793
Form Id
42716077
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040006
Ins Broker 01 Name
WILLIS CORRON LIFE INC
Ins Broker 01 Street Addr
PO BOX 73015
Ins Broker 01 City
DALLAS TX
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
75373
Ins Broker Comm Pd 01 Amount
$10,310
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 8
Filing Id
84037343006793
Form Id
42716078
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040007
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
$65,553
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 9
Filing Id
84037343006793
Form Id
42716079
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040008
Ins Broker 01 Name
WILLIS CORROON LIFE INS
Ins Broker 01 Street Addr
PO BOX
Ins Broker 01 City
DALLAS
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
75373
Ins Broker Comm Pd 01 Amount
$30,335
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 10
Filing Id
84037343006793
Form Id
42716080
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040009
Ins Broker 01 Name
WILLIS CORROON LIFE INS
Ins Broker 01 Street Addr
PO BOX
Ins Broker 01 City
DALLAS
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
75373
Ins Broker Comm Pd 01 Amount
$40,131
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 11
Filing Id
84037343006793
Form Id
42716081
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040010
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 12
Filing Id
84037343006793
Form Id
42716082
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040011
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 13
Filing Id
84037343006793
Form Id
42716085
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040014
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 14
Filing Id
84037343006793
Form Id
42716086
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040015
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 15
Filing Id
84037343006793
Form Id
42716087
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040016
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 16
Filing Id
84037343006793
Form Id
42716088
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040017
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 17
Filing Id
84037343006793
Form Id
42716089
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040018
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 18
Filing Id
84037343006793
Form Id
42716091
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040020
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 19
Filing Id
84037343006793
Form Id
42716092
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040021
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 20
Filing Id
84037343006793
Form Id
42716084
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
2040373343006040013
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 21
Ins Carrier Name: UNITED HEALTHCARE
Filing Id
84037343006793
Form Id
42716073
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
UNITED HEALTHCARE
Ins Carrier EIN
36-2739571
Ins Carrier Naic Code
79413
Ins Contract Num
209405
Ins Prsn Covered End of year Count
9,003
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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
M
Wlfr Premium Rcvd Amount
$694,830
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$694,830
Wlfr Claims Paid Amount
$32,194
Wlfr Incr Reserve Amount
$99
Wlfr Incurred Claim Amount
$32,293
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$5,143,152
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$3,486
Wlfr Ret Oth Chrgs Amount
$8,228
Wlfr Ret Total Amount
$5,154,866
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
$63,800,975
Wlfr Acquis Cost Amount
$0
Row 22
Ins Carrier Name: RELAISTAR LIFE INSURANCE CO/ ING
Filing Id
84037343006793
Form Id
42716074
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
RELAISTAR LIFE INSURANCE CO/ ING
Ins Carrier EIN
41-0451140
Ins Carrier Naic Code
67105
Ins Contract Num
57051
Ins Prsn Covered End of year Count
24,064
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
Ins Broker Comm Total Amount
$59,449
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 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
$856,436
Wlfr Acquis Cost Amount
$0
Row 23
Ins Carrier Name: ZURICH
Filing Id
84037343006793
Form Id
42716075
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
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
12,074
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
Ins Broker Comm Total Amount
$45,562
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
$455,624
Wlfr Acquis Cost Amount
$0
Row 24
Ins Carrier Name: PROVIDENT LIFE INS
Filing Id
84037343006793
Form Id
42716076
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
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
10,500
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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
DF
Wlfr Premium Rcvd Amount
$751,807
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$751,807
Wlfr Claims Paid Amount
$725,000
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$725,000
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
$26,807
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$26,807
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
$5,503,576
Wlfr Acquis Cost Amount
$0
Row 25
Ins Carrier Name: UNUM LIFE INSURANCE
Filing Id
84037343006793
Form Id
42716077
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
UNUM LIFE INSURANCE
Ins Carrier EIN
01-0278678
Ins Carrier Naic Code
62235
Ins Contract Num
565242
Ins Prsn Covered End of year Count
1,619
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
Ins Broker Comm Total Amount
$10,310
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 Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$113,268
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$113,268
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
$10,228
Wlfr Acquis Cost Amount
$0
Row 26
Ins Carrier Name: PROVIDENT LIFE & ACCIDENT INS CO
Filing Id
84037343006793
Form Id
42716078
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
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
4,547
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
Ins Broker Comm Total Amount
$65,553
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
$655,531
Wlfr Acquis Cost Amount
$0
Row 27
Ins Carrier Name: CONNECTICUT GENERAL LIFE INS
Filing Id
84037343006793
Form Id
42716080
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
CONNECTICUT GENERAL LIFE INS
Ins Carrier EIN
06-0303370
Ins Carrier Naic Code
62308
Ins Contract Num
060303370
Ins Prsn Covered End of year Count
6,685
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
Ins Broker Comm Total Amount
$40,131
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
$375,814
Wlfr Acquis Cost Amount
$0
Wlfr Acquis Cost Text
ASO SERVICE FEES PAID BY CUSTOMER TO CONN GENL LIFE I NSURANCE CO
Row 28
Ins Carrier Name: HIGHMARK BLUE CROSS BLUE SHIELD
Filing Id
84037343006793
Form Id
42716081
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
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
1,520
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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
$2,643,178
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$2,643,178
Wlfr Claims Paid Amount
$2,385,020
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$2,385,020
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
$245,917
Wlfr Ret Total Amount
$245,917
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 29
Ins Carrier Name: KAISER PERMANENTE
Filing Id
84037343006793
Form Id
42716082
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
KAISER PERMANENTE
Ins Carrier EIN
94-1340523
Ins Contract Num
81980002
Ins Prsn Covered End of year Count
5
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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 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
$132,551
Wlfr Acquis Cost Amount
$0
Row 30
Ins Carrier Name: KAISER PERMAMENTE
Filing Id
84037343006793
Form Id
42716083
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
KAISER PERMAMENTE
Ins Carrier EIN
94-1340523
Ins Contract Num
81980003
Ins Prsn Covered End of year Count
5
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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 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
$7,935
Wlfr Acquis Cost Amount
$0
Row 31
Ins Carrier Name: KAISER PERMANENTE
Filing Id
84037343006793
Form Id
42716084
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
KAISER PERMANENTE
Ins Carrier EIN
94-1340523
Ins Contract Num
10052001
Ins Prsn Covered End of year Count
24
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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 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
$68,266
Wlfr Acquis Cost Amount
$0
Row 32
Ins Carrier Name: KAISER PERMANENTE
Filing Id
84037343006793
Form Id
42716085
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
KAISER PERMANENTE
Ins Carrier EIN
94-1340523
Ins Contract Num
100520102
Ins Prsn Covered End of year Count
26
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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 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
$72,355
Wlfr Acquis Cost Amount
$0
Row 33
Ins Carrier Name: HANSON AGG EST GYPSUM RETIREES
Filing Id
84037343006793
Form Id
42716087
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
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
5
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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
$22,244
Wlfr Acquis Cost Amount
$0
Row 34
Ins Carrier Name: HANSON AGG WEST RETIRED
Filing Id
84037343006793
Form Id
42716088
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
HANSON AGG WEST RETIRED
Ins Carrier EIN
94-1340523
Ins Contract Num
8217-0080
Ins Prsn Covered End of year Count
239
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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
$289,392
Wlfr Acquis Cost Amount
$0
Row 35
Ins Carrier Name: HMO-KAISER PERMANENTE
Filing Id
84037343006793
Form Id
42716089
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
HMO-KAISER PERMANENTE
Ins Carrier EIN
94-1340523
Ins Contract Num
35-0000
Ins Prsn Covered End of year Count
414
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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
$772,349
Wlfr Acquis Cost Amount
$0
Row 36
Ins Carrier Name: KAISER FOUNDATION HEALTH PLAN
Filing Id
84037343006793
Form Id
42716090
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
KAISER FOUNDATION HEALTH PLAN
Ins Carrier EIN
94-1340523
Ins Contract Num
35-0002
Ins Prsn Covered End of year Count
146
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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
$269,895
Wlfr Acquis Cost Amount
$0
Row 37
Ins Carrier Name: HANSON PERMANENTE/COBRA
Filing Id
84037343006793
Form Id
42716091
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
HANSON PERMANENTE/COBRA
Ins Carrier EIN
94-1340523
Ins Contract Num
35-7000
Ins Prsn Covered End of year Count
5
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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
$1,889
Wlfr Acquis Cost Amount
$0
Row 38
Ins Carrier Name: METROPOLITAN LIFE
Filing Id
84037343006793
Form Id
42716092
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
METROPOLITAN LIFE
Ins Carrier EIN
13-5581829
Ins Carrier Naic Code
65978
Ins Contract Num
73955-G
Ins Prsn Covered End of year Count
546
Ins Policy From Date
2001-07-01
Ins Policy To Date
2002-06-30
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 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
$56,813
Wlfr Acquis Cost Amount
$0
Row 39
Ins Carrier Name: HANSON AGG WEST - RETIREES
Filing Id
84037343006793
Form Id
42716086
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
Ins Carrier Name
HANSON AGG WEST - RETIREES
Ins Carrier EIN
94-1340523
Ins Contract Num
8217-0060
Ins Prsn Covered End of year Count
5
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
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
$190,144
Wlfr Acquis Cost Amount
$0
Row 40
Ins Carrier Name: CONNECTICUT GENERAL LIFE INS
Filing Id
84037343006793
Form Id
42716079
Schedule A EIN
22-3473702
Schedule A Plan Num
524
Schedule A Plan Year Begin Date
2002-01-01
Schedule A Tax Period
20021231
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
6,685
Ins Policy From Date
2002-01-01
Ins Policy To Date
2002-12-31
Ins Broker Comm Total Amount
$30,335
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
$1,011,169
Wlfr Acquis Cost Amount
$0
Wlfr Acquis Cost Text
ASO SERVICE FEES PAID BY CUSTOMER TO CONN GENL LIFE I NSURANCE CO