Fidelity bond in place
Not reported
Filing
Seattle Goodwill Industries Health and Welfare Benefit Plan
Seattle Goodwill • EIN 91-0568708 • Plan year 2003
Filing Insights
Participants
Flat413 → 413
0 • 0.00%
Assets
No comparison- → -
No earlier value available.
Investment Management Fee
-
Admin expenses - • Total expenses -
Filing Details
ContextNo event flags were generated for this filing.
Status Flags
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 / Filing | Filings | Participants | Assets | Contributions | Contrib./Participant |
|---|---|---|---|---|---|
| 2023 | 2 | 2,013 | $13,742,084 | $2,234,149 | $1,110iApproximate average salary by contribution assumption: employee only about $27,747 at 4% or $18,498 at 6%; with 50% employer match about $18,498 at 4% or $12,332 at 6%; with 100% employer match about $13,873 at 4% or $9,249 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 2,013 | $13,742,084 | $2,234,149 | $1,110iApproximate average salary by contribution assumption: employee only about $27,747 at 4% or $18,498 at 6%; with 50% employer match about $18,498 at 4% or $12,332 at 6%; with 100% employer match about $13,873 at 4% or $9,249 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 1,932 | - | - | - |
| 2022 | 2 | 3,329 | $13,257,887 | $1,942,102 | $583iApproximate average salary by contribution assumption: employee only about $14,585 at 4% or $9,723 at 6%; with 50% employer match about $9,723 at 4% or $6,482 at 6%; with 100% employer match about $7,292 at 4% or $4,862 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 3,329 | $13,257,887 | $1,942,102 | $583iApproximate average salary by contribution assumption: employee only about $14,585 at 4% or $9,723 at 6%; with 50% employer match about $9,723 at 4% or $6,482 at 6%; with 100% employer match about $7,292 at 4% or $4,862 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 2,078 | - | - | - |
| 2021 | 2 | 2,906 | $11,008,143 | $1,614,187 | $555iApproximate average salary by contribution assumption: employee only about $13,887 at 4% or $9,258 at 6%; with 50% employer match about $9,258 at 4% or $6,172 at 6%; with 100% employer match about $6,943 at 4% or $4,629 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 2,906 | $11,008,143 | $1,614,187 | $555iApproximate average salary by contribution assumption: employee only about $13,887 at 4% or $9,258 at 6%; with 50% employer match about $9,258 at 4% or $6,172 at 6%; with 100% employer match about $6,943 at 4% or $4,629 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 2,128 | - | - | - |
| 2020 | 2 | 2,114 | $12,466,811 | $1,138,337 | $538iApproximate average salary by contribution assumption: employee only about $13,462 at 4% or $8,975 at 6%; with 50% employer match about $8,975 at 4% or $5,983 at 6%; with 100% employer match about $6,731 at 4% or $4,487 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 2,114 | $12,466,811 | $1,138,337 | $538iApproximate average salary by contribution assumption: employee only about $13,462 at 4% or $8,975 at 6%; with 50% employer match about $8,975 at 4% or $5,983 at 6%; with 100% employer match about $6,731 at 4% or $4,487 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 1,953 | - | - | - |
| 2019 | 2 | 2,231 | $10,427,829 | $1,603,079 | $719iApproximate average salary by contribution assumption: employee only about $17,964 at 4% or $11,976 at 6%; with 50% employer match about $11,976 at 4% or $7,984 at 6%; with 100% employer match about $8,982 at 4% or $5,988 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 2,231 | $10,427,829 | $1,603,079 | $719iApproximate average salary by contribution assumption: employee only about $17,964 at 4% or $11,976 at 6%; with 50% employer match about $11,976 at 4% or $7,984 at 6%; with 100% employer match about $8,982 at 4% or $5,988 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 2,201 | - | - | - |
| 2018 | 2 | 2,260 | $9,405,841 | $1,185,190 | $524iApproximate average salary by contribution assumption: employee only about $13,111 at 4% or $8,740 at 6%; with 50% employer match about $8,740 at 4% or $5,827 at 6%; with 100% employer match about $6,555 at 4% or $4,370 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 2,260 | $9,405,841 | $1,185,190 | $524iApproximate average salary by contribution assumption: employee only about $13,111 at 4% or $8,740 at 6%; with 50% employer match about $8,740 at 4% or $5,827 at 6%; with 100% employer match about $6,555 at 4% or $4,370 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 2,201 | - | - | - |
| 2017 | 2 | 3,220 | $9,133,510 | $1,124,645 | $349iApproximate average salary by contribution assumption: employee only about $8,732 at 4% or $5,821 at 6%; with 50% employer match about $5,821 at 4% or $3,881 at 6%; with 100% employer match about $4,366 at 4% or $2,911 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 3,220 | $9,133,510 | $1,124,645 | $349iApproximate average salary by contribution assumption: employee only about $8,732 at 4% or $5,821 at 6%; with 50% employer match about $5,821 at 4% or $3,881 at 6%; with 100% employer match about $4,366 at 4% or $2,911 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 2,201 | - | - | - |
| 2016 | 2 | 2,119 | $8,219,514 | $1,233,852 | $582iApproximate average salary by contribution assumption: employee only about $14,557 at 4% or $9,705 at 6%; with 50% employer match about $9,705 at 4% or $6,470 at 6%; with 100% employer match about $7,279 at 4% or $4,852 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 2,119 | $8,219,514 | $1,233,852 | $582iApproximate average salary by contribution assumption: employee only about $14,557 at 4% or $9,705 at 6%; with 50% employer match about $9,705 at 4% or $6,470 at 6%; with 100% employer match about $7,279 at 4% or $4,852 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 2,010 | - | - | - |
| 2015 | 2 | 3,468 | $6,702,904 | $1,203,943 | $347iApproximate average salary by contribution assumption: employee only about $8,679 at 4% or $5,786 at 6%; with 50% employer match about $5,786 at 4% or $3,857 at 6%; with 100% employer match about $4,339 at 4% or $2,893 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 3,468 | $6,702,904 | $1,203,943 | $347iApproximate average salary by contribution assumption: employee only about $8,679 at 4% or $5,786 at 6%; with 50% employer match about $5,786 at 4% or $3,857 at 6%; with 100% employer match about $4,339 at 4% or $2,893 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 2,218 | - | - | - |
| 2014 | 2 | 3,063 | $6,045,438 | $789,219 | $258iApproximate average salary by contribution assumption: employee only about $6,442 at 4% or $4,294 at 6%; with 50% employer match about $4,294 at 4% or $2,863 at 6%; with 100% employer match about $3,221 at 4% or $2,147 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 3,063 | $6,045,438 | $789,219 | $258iApproximate average salary by contribution assumption: employee only about $6,442 at 4% or $4,294 at 6%; with 50% employer match about $4,294 at 4% or $2,863 at 6%; with 100% employer match about $3,221 at 4% or $2,147 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 2,095 | - | - | - |
| 2013 | 2 | 2,619 | $5,286,872 | $881,058 | $336iApproximate average salary by contribution assumption: employee only about $8,410 at 4% or $5,607 at 6%; with 50% employer match about $5,607 at 4% or $3,738 at 6%; with 100% employer match about $4,205 at 4% or $2,803 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 2,619 | $5,286,872 | $881,058 | $336iApproximate average salary by contribution assumption: employee only about $8,410 at 4% or $5,607 at 6%; with 50% employer match about $5,607 at 4% or $3,738 at 6%; with 100% employer match about $4,205 at 4% or $2,803 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 1,281 | - | - | - |
| 2012 | 2 | 2,456 | $3,865,473 | $632,594 | $258iApproximate average salary by contribution assumption: employee only about $6,439 at 4% or $4,293 at 6%; with 50% employer match about $4,293 at 4% or $2,862 at 6%; with 100% employer match about $3,220 at 4% or $2,146 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 2,456 | $3,865,473 | $632,594 | $258iApproximate average salary by contribution assumption: employee only about $6,439 at 4% or $4,293 at 6%; with 50% employer match about $4,293 at 4% or $2,862 at 6%; with 100% employer match about $3,220 at 4% or $2,146 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 1,112 | - | - | - |
| 2011 | 2 | 2,208 | $2,877,166 | $581,618 | $263iApproximate average salary by contribution assumption: employee only about $6,585 at 4% or $4,390 at 6%; with 50% employer match about $4,390 at 4% or $2,927 at 6%; with 100% employer match about $3,293 at 4% or $2,195 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 2,208 | $2,877,166 | $581,618 | $263iApproximate average salary by contribution assumption: employee only about $6,585 at 4% or $4,390 at 6%; with 50% employer match about $4,390 at 4% or $2,927 at 6%; with 100% employer match about $3,293 at 4% or $2,195 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 1,028 | - | - | - |
| 2010 | 2 | 1,937 | $2,423,852 | $552,698 | $285iApproximate average salary by contribution assumption: employee only about $7,133 at 4% or $4,756 at 6%; with 50% employer match about $4,756 at 4% or $3,170 at 6%; with 100% employer match about $3,567 at 4% or $2,378 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 1,937 | $2,423,852 | $552,698 | $285iApproximate average salary by contribution assumption: employee only about $7,133 at 4% or $4,756 at 6%; with 50% employer match about $4,756 at 4% or $3,170 at 6%; with 100% employer match about $3,567 at 4% or $2,378 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 934 | - | - | - |
| 2009 | 2 | 1,536 | $1,727,153 | $485,638 | $316iApproximate average salary by contribution assumption: employee only about $7,904 at 4% or $5,270 at 6%; with 50% employer match about $5,270 at 4% or $3,513 at 6%; with 100% employer match about $3,952 at 4% or $2,635 at 6%. |
| Seattle Goodwill Industries 403(B) Plan | - | 1,536 | $1,727,153 | $485,638 | $316iApproximate average salary by contribution assumption: employee only about $7,904 at 4% or $5,270 at 6%; with 50% employer match about $5,270 at 4% or $3,513 at 6%; with 100% employer match about $3,952 at 4% or $2,635 at 6%. |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 848 | - | - | - |
| 2008 | 2 | 746 | $0 | $0 | - |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 746 | - | - | - |
| Seattle Goodwill Industries 403(B) Plan | - | 0 | - | - | - |
| 2007 | 2 | 463 | $0 | $0 | - |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 463 | - | - | - |
| Seattle Goodwill Industries 403(B) Plan | - | 0 | - | - | - |
| 2006 | 2 | 476 | $0 | $0 | - |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 476 | - | - | - |
| Seattle Goodwill Industries 403(B) Plan | - | 0 | - | - | - |
| 2005 | 2 | 507 | $0 | $0 | - |
| Seattle Goodwill Industries 403(B) Plan | - | 0 | - | - | - |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 507 | - | - | - |
| 2004 | 1 | 1,030 | $0 | $0 | - |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 1,030 | - | - | - |
| 2003 | 1 | 413 | $0 | $0 | - |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | Current | 413 | - | - | - |
| 2002 | 2 | 390 | $0 | $0 | - |
| WELFARE BENEFIT PLAN - DENTAL | - | 390 | - | - | - |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 184 | - | - | - |
| 2001 | 2 | 339 | $0 | $0 | - |
| WELFARE BENEFIT PLAN - DENTAL | - | 339 | - | - | - |
| Seattle Goodwill Industries Health and Welfare Benefit Plan | - | 132 | - | - | - |
| 1999 | 1 | 0 | $0 | $0 | - |
| Seattle Goodwill Flexible Benefit Plan | - | 0 | - | - | - |
Schedule Details
Schedule A
- Row 1
- Filing Id
- 91037238626025
- Form Id
- 60849976
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 3040375223165030002
- Ins Broker 01 Name
- NETWORK ADMINISTRATORS INS AGENCY
- Ins Broker 01 Street Addr
- 414 MAIN ST. SUITE 103
- Ins Broker 01 City
- PORT HEFFERSON
- Ins Broker 01 State
- NY
- Ins Broker 01 ZIP Code
- 11777
- Ins Broker Comm Pd 01 Amount
- $40,260
- Ins Broker Fees Pd 01 Amount
- $0
- Ins Broker 01 Code
- 3
- Row 2
- Filing Id
- 91037238626025
- Form Id
- 60849979
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 0
- Image Form Id
- 3040375223165030005
- Ins Broker 01 Name
- THE BALANCED PROGRAM
- Ins Broker 01 Street Addr
- 1310 MERCER ST 200
- Ins Broker 01 City
- SEATTLE WA 981095588
- Ins Broker Comm Pd 01 Amount
- $602
- Ins Broker Fees Pd 01 Amount
- $0
- Ins Broker 01 Code
- 3
- Row 3
- Filing Id
- 91037238626025
- Form Id
- 60849978
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 1
- Row Num
- 0
- Image Form Id
- 3040375223165030004
- Ins Broker Comm Pd 01 Amount
- $0
- Ins Broker Fees Pd 01 Amount
- $0
- Ins Broker 01 Code
- 3
- Row 4
- Filing Id
- 91037238626025
- Form Id
- 60849977
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 0
- Image Form Id
- 3040375223165030003
- Ins Broker 01 Name
- THE BALANCED PROGRAM
- Ins Broker 01 Street Addr
- 1310 MERCER ST. #200
- Ins Broker 01 City
- SEATTLE WA 98109-5588
- Ins Broker Comm Pd 01 Amount
- $3,710
- Ins Broker Fees Pd 01 Amount
- $0
- Ins Broker 01 Code
- 3
- Row 5
- Filing Id
- 91037238626025
- Form Id
- 60849978
- Page Id
- 2
- Page Seq
- 0
- Page Row Num
- 2
- Row Num
- 1
- Image Form Id
- 3040375223165030004
- Ins Broker 01 Name
- THE BALANCED PROGRAM
- Ins Broker 01 Street Addr
- 1310 MEREER ST #200
- Ins Broker 01 City
- SEATTLE WA 98109-5558
- Ins Broker Comm Pd 01 Amount
- $241
- Ins Broker Fees Pd 01 Amount
- $0
- Ins Broker 01 Code
- 3
- Row 6
- Ins Carrier Name: JEFFERSON PILOT FINANCIAL INS CO
- Filing Id
- 91037238626025
- Form Id
- 60849979
- Schedule A EIN
- 91-0568708
- Schedule A Plan Num
- 501
- Schedule A Plan Year Begin Date
- 2003-12-01
- Schedule A Tax Period
- 20041130
- Ins Carrier Name
- JEFFERSON PILOT FINANCIAL INS CO
- Ins Carrier EIN
- 62-0395665
- Ins Carrier Naic Code
- 70254
- Ins Contract Num
- 000860052162
- Ins Prsn Covered End of year Count
- 396
- Ins Policy From Date
- 2003-12-01
- Ins Policy To Date
- 2004-11-30
- Ins Broker Comm Total Amount
- $602
- 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
- No
- 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
- $6,016
- Wlfr Acquis Cost Amount
- $0
- Row 7
- Ins Carrier Name: METROPOLITAN LIFE INSURANCE CO
- Filing Id
- 91037238626025
- Form Id
- 60849977
- Schedule A EIN
- 91-0568708
- Schedule A Plan Num
- 501
- Schedule A Plan Year Begin Date
- 2003-12-01
- Schedule A Tax Period
- 20041130
- Ins Carrier Name
- METROPOLITAN LIFE INSURANCE CO
- Ins Carrier EIN
- 13-5581829
- Ins Carrier Naic Code
- 65978
- Ins Contract Num
- 5723242
- Ins Prsn Covered End of year Count
- 413
- Ins Policy From Date
- 2005-12-01
- Ins Policy To Date
- 2004-11-30
- Ins Broker Comm Total Amount
- $3,710
- 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
- $146,274
- Wlfr Acquis Cost Amount
- $0
- Row 8
- Ins Carrier Name: GROUP HEALTH COOPERATIVE
- Filing Id
- 91037238626025
- Form Id
- 60849978
- Schedule A EIN
- 91-0568708
- Schedule A Plan Num
- 501
- Schedule A Plan Year Begin Date
- 2003-12-01
- Schedule A Tax Period
- 20041130
- Ins Carrier Name
- GROUP HEALTH COOPERATIVE
- Ins Carrier EIN
- 91-0511770
- Ins Carrier Naic Code
- 95672
- Ins Contract Num
- 1181700
- Ins Prsn Covered End of year Count
- 1
- Ins Policy From Date
- 2003-12-01
- Ins Policy To Date
- 2004-11-30
- Ins Broker Comm Total Amount
- $241
- 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
- $5,223
- Wlfr Acquis Cost Amount
- $0
- Row 9
- Ins Carrier Name: GREAT WEST HEALTHCARE
- Filing Id
- 91037238626025
- Form Id
- 60849976
- Schedule A EIN
- 91-0568708
- Schedule A Plan Num
- 501
- Schedule A Plan Year Begin Date
- 2003-12-01
- Schedule A Tax Period
- 20041130
- Ins Carrier Name
- GREAT WEST HEALTHCARE
- Ins Carrier EIN
- 84-0467907
- Ins Carrier Naic Code
- 68322
- Ins Contract Num
- 358191
- Ins Prsn Covered End of year Count
- 171
- Ins Policy From Date
- 2003-12-01
- Ins Policy To Date
- 2004-11-30
- Ins Broker Comm Total Amount
- $40,260
- 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
- $103,877
- Wlfr Acquis Cost Amount
- $0