Civic Intelligence
Filing

Group Health & Welfare Plan

Graham & Dunn PC • EIN 91-1120759 • Plan year 2000

Company ProfileSource Archive
Filing Insights

Participants

Up

133 → 144

11 • 8.27%

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
2011295$0$0-
Group Health & Welfare Plan-90---
GRAHAM AND DUNN LIFE AND DISABILITY PLAN-95---
20102100$0$0-
GRAHAM AND DUNN LIFE AND DISABILITY PLAN-99---
Group Health & Welfare Plan-100---
20092108$0$0-
GRAHAM AND DUNN LIFE AND DISABILITY PLAN-103---
Group Health & Welfare Plan-108---
20082110$0$0-
Group Health & Welfare Plan-108---
GRAHAM & DUNN LIFE & DISABILITY PLAN-110---
20072169$0$0-
Group Health & Welfare Plan-169---
GRAHAM & DUNN LIFE & DISABILITY PLAN-121---
20062119$0$0-
Group Health & Welfare Plan-119---
GRAHAM & DUNN LIFE & DISABILITY PLAN-119---
20052115$0$0-
Group Health & Welfare Plan-109---
GRAHAM & DUNN LIFE & DISABILITY PLAN-115---
20042114$0$0-
GRAHAM & DUNN LIFE & DISABILITY PLAN-113---
Group Health & Welfare Plan-114---
20031125$0$0-
Group Health & Welfare Plan-125---
20021134$0$0-
Group Health & Welfare Plan-134---
20011149$0$0-
Group Health & Welfare Plan-149---
20001144$0$0-
Group Health & Welfare PlanCurrent144---
Schedule Details

Schedule A

Row 1
Filing Id
84037028347312
Form Id
12018824
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
20372028347060004
Ins Broker 01 Name
P. ROBERT BROWN, INC.
Ins Broker 01 Street Addr
600 STEWART STREET, SUITE 1919
Ins Broker 01 City
SEATTLE
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
98101
Ins Broker Comm Pd 01 Amount
$4,103
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 2
Filing Id
84037028347312
Form Id
12018822
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
20372028347060002
Ins Broker 01 Name
P. ROBERT BROWN, INC.
Ins Broker 01 Street Addr
600 STEWART STREET, SUITE 1919
Ins Broker 01 City
SEATTLE
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
98101
Ins Broker Comm Pd 01 Amount
$633
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 3
Filing Id
84037028347312
Form Id
12018823
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
20372028347060003
Ins Broker 01 Name
P. ROBERT BROWN, INC.
Ins Broker 01 Street Addr
600 STEWART STREET, SUITE 1919
Ins Broker 01 City
SEATTLE
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
98101
Ins Broker Comm Pd 01 Amount
$17,771
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 4
Filing Id
84037028347312
Form Id
12018825
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
20372028347060005
Ins Broker 01 Name
PROFESSIONAL BENEFIT CONSULTANTS
Ins Broker 01 Street Addr
2731 77TH AVENUE SE, SUITE 201
Ins Broker 01 City
MERCER ISLAND
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
98040
Ins Broker Comm Pd 01 Amount
$10,727
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 5
Filing Id
84037028347312
Form Id
12018826
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
20372028347060006
Ins Broker 01 Name
PROFESSIONAL BENEFITS CONSULTANTS
Ins Broker 01 Street Addr
2731 77TH AVENUE SE, SUITE 201
Ins Broker 01 City
MERCER ISLAND
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
98040
Ins Broker Comm Pd 01 Amount
$2,887
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 6
Filing Id
84037028347312
Form Id
12018827
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
20372028347060007
Ins Broker 01 Name
PROFESSIONAL BENEFIT CONSULTANTS
Ins Broker 01 Street Addr
2731 77TH AVENUE SE, SUITE 201
Ins Broker 01 City
MERCER ISLAND
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
98040
Ins Broker Comm Pd 01 Amount
$7,287
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 7
Ins Carrier Name: GROUP HEALTH COOPERATIVE
Filing Id
84037028347312
Form Id
12018822
Schedule A EIN
91-1120759
Schedule A Plan Num
504
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
GROUP HEALTH COOPERATIVE
Ins Carrier EIN
91-0511770
Ins Carrier Naic Code
95672
Ins Contract Num
0143100
Ins Prsn Covered End of year Count
4
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$633
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
AHJ
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
$16,381
Wlfr Acquis Cost Amount
$0
Row 8
Ins Carrier Name: UNITED HEALTHCARE
Filing Id
84037028347312
Form Id
12018823
Schedule A EIN
91-1120759
Schedule A Plan Num
504
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
UNITED HEALTHCARE
Ins Carrier EIN
36-2739571
Ins Carrier Naic Code
79413
Ins Contract Num
198922
Ins Prsn Covered End of year Count
137
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$17,771
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
AHM
Wlfr Type Bnft Oth Text
POINT OF SERVICE CONTRACT
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
$461,602
Wlfr Acquis Cost Amount
$0
Row 9
Ins Carrier Name: WASHINGTON DENTAL SERVICE
Filing Id
84037028347312
Form Id
12018824
Schedule A EIN
91-1120759
Schedule A Plan Num
504
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
WASHINGTON DENTAL SERVICE
Ins Carrier EIN
91-0821480
Ins Carrier Naic Code
47341
Ins Contract Num
812
Ins Prsn Covered End of year Count
143
Ins Policy From Date
2000-01-01
Ins Policy To Date
2000-12-31
Ins Broker Comm Total Amount
$4,103
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
$102,507
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$102,507
Wlfr Claims Paid Amount
$94,097
Wlfr Incr Reserve Amount
$2,500
Wlfr Incurred Claim Amount
$96,597
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$4,103
Wlfr Ret Admin Amount
$8,402
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
$12,505
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$9,500
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$0
Wlfr Acquis Cost Amount
$0
Row 10
Ins Carrier Name: STANDARD INSURANCE COMPANY
Filing Id
84037028347312
Form Id
12018825
Schedule A EIN
91-1120759
Schedule A Plan Num
504
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
STANDARD INSURANCE COMPANY
Ins Carrier EIN
93-0242990
Ins Carrier Naic Code
69019
Ins Contract Num
445424
Ins Prsn Covered End of year Count
132
Ins Policy From Date
2000-03-01
Ins Policy To Date
2001-02-28
Ins Broker Comm Total Amount
$10,727
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
$65,664
Wlfr Unpaid Due Amount
$-7,826
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$57,838
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$2,360
Wlfr Incurred Claim Amount
$2,360
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$10,727
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$280
Wlfr Ret Oth Expense Amount
$4,940
Wlfr Ret Taxes Amount
$1,157
Wlfr Ret Charges Amount
$2,892
Wlfr Ret Oth Chrgs Amount
$35,482
Wlfr Ret Total Amount
$55,478
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$13,535
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$0
Wlfr Acquis Cost Amount
$0
Row 11
Ins Carrier Name: STANDARD INSURANCE COMPANY
Filing Id
84037028347312
Form Id
12018826
Schedule A EIN
91-1120759
Schedule A Plan Num
504
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
STANDARD INSURANCE COMPANY
Ins Carrier EIN
93-0242990
Ins Carrier Naic Code
69019
Ins Contract Num
44524
Ins Prsn Covered End of year Count
132
Ins Policy From Date
2000-03-01
Ins Policy To Date
2001-02-28
Ins Broker Comm Total Amount
$2,887
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
$19,795
Wlfr Unpaid Due Amount
$-2,434
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$17,361
Wlfr Claims Paid Amount
$6,171
Wlfr Incr Reserve Amount
$101
Wlfr Incurred Claim Amount
$6,272
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$2,887
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$1,915
Wlfr Ret Taxes Amount
$347
Wlfr Ret Charges Amount
$868
Wlfr Ret Oth Chrgs Amount
$5,072
Wlfr Ret Total Amount
$11,089
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$1,799
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$0
Wlfr Acquis Cost Amount
$0
Row 12
Ins Carrier Name: STANDARD INSURANCE COMPANY
Filing Id
84037028347312
Form Id
12018827
Schedule A EIN
91-1120759
Schedule A Plan Num
504
Schedule A Plan Year Begin Date
2000-01-01
Schedule A Tax Period
20001231
Ins Carrier Name
STANDARD INSURANCE COMPANY
Ins Carrier EIN
93-0242990
Ins Carrier Naic Code
69019
Ins Contract Num
44524
Ins Prsn Covered End of year Count
132
Ins Policy From Date
2000-03-01
Ins Policy To Date
2001-02-28
Ins Broker Comm Total Amount
$7,287
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
$46,644
Wlfr Unpaid Due Amount
$-5,918
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$40,726
Wlfr Claims Paid Amount
$45,399
Wlfr Incr Reserve Amount
$123,936
Wlfr Incurred Claim Amount
$169,335
Wlfr Claims Chrgd Amount
$169,335
Wlfr Ret Commissions Amount
$7,287
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$6,241
Wlfr Ret Taxes Amount
$815
Wlfr Ret Charges Amount
$2,851
Wlfr Ret Oth Chrgs Amount
$815
Wlfr Ret Total Amount
$18,009
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$137,746
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$0
Wlfr Acquis Cost Amount
$0