Civic Intelligence
Filing

CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN

Construction Testing & Engineering, • EIN 93-0997190 • Plan year 2005

Company ProfileSource Archive
Filing Insights

Participants

Down

143 → 138

-5 • -3.50%

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
202210$0$625,640-
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-0$0$625,640-
20211109$5,310,501$805,796$7,393iApproximate average salary by contribution assumption: employee only about $184,816 at 4% or $123,210 at 6%; with 50% employer match about $123,210 at 4% or $82,140 at 6%; with 100% employer match about $92,408 at 4% or $61,605 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-109$5,310,501$805,796$7,393iApproximate average salary by contribution assumption: employee only about $184,816 at 4% or $123,210 at 6%; with 50% employer match about $123,210 at 4% or $82,140 at 6%; with 100% employer match about $92,408 at 4% or $61,605 at 6%.
20201101$5,095,760$911,873$9,028iApproximate average salary by contribution assumption: employee only about $225,711 at 4% or $150,474 at 6%; with 50% employer match about $150,474 at 4% or $100,316 at 6%; with 100% employer match about $112,856 at 4% or $75,237 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-101$5,095,760$911,873$9,028iApproximate average salary by contribution assumption: employee only about $225,711 at 4% or $150,474 at 6%; with 50% employer match about $150,474 at 4% or $100,316 at 6%; with 100% employer match about $112,856 at 4% or $75,237 at 6%.
2019189$5,231,542$1,685,395$18,937iApproximate average salary by contribution assumption: employee only about $473,426 at 4% or $315,617 at 6%; with 50% employer match about $315,617 at 4% or $210,411 at 6%; with 100% employer match about $236,713 at 4% or $157,809 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-89$5,231,542$1,685,395$18,937iApproximate average salary by contribution assumption: employee only about $473,426 at 4% or $315,617 at 6%; with 50% employer match about $315,617 at 4% or $210,411 at 6%; with 100% employer match about $236,713 at 4% or $157,809 at 6%.
2018182$4,498,179$579,064$7,062iApproximate average salary by contribution assumption: employee only about $176,544 at 4% or $117,696 at 6%; with 50% employer match about $117,696 at 4% or $78,464 at 6%; with 100% employer match about $88,272 at 4% or $58,848 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-82$4,498,179$579,064$7,062iApproximate average salary by contribution assumption: employee only about $176,544 at 4% or $117,696 at 6%; with 50% employer match about $117,696 at 4% or $78,464 at 6%; with 100% employer match about $88,272 at 4% or $58,848 at 6%.
2017183$4,881,467$661,507$7,970iApproximate average salary by contribution assumption: employee only about $199,249 at 4% or $132,833 at 6%; with 50% employer match about $132,833 at 4% or $88,555 at 6%; with 100% employer match about $99,625 at 4% or $66,416 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-83$4,881,467$661,507$7,970iApproximate average salary by contribution assumption: employee only about $199,249 at 4% or $132,833 at 6%; with 50% employer match about $132,833 at 4% or $88,555 at 6%; with 100% employer match about $99,625 at 4% or $66,416 at 6%.
2016193$4,552,207$524,274$5,637iApproximate average salary by contribution assumption: employee only about $140,934 at 4% or $93,956 at 6%; with 50% employer match about $93,956 at 4% or $62,637 at 6%; with 100% employer match about $70,467 at 4% or $46,978 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-93$4,552,207$524,274$5,637iApproximate average salary by contribution assumption: employee only about $140,934 at 4% or $93,956 at 6%; with 50% employer match about $93,956 at 4% or $62,637 at 6%; with 100% employer match about $70,467 at 4% or $46,978 at 6%.
2015285$5,038,887$502,926$5,917iApproximate average salary by contribution assumption: employee only about $147,919 at 4% or $98,613 at 6%; with 50% employer match about $98,613 at 4% or $65,742 at 6%; with 100% employer match about $73,960 at 4% or $49,306 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-85$5,038,887$502,926$5,917iApproximate average salary by contribution assumption: employee only about $147,919 at 4% or $98,613 at 6%; with 50% employer match about $98,613 at 4% or $65,742 at 6%; with 100% employer match about $73,960 at 4% or $49,306 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-63---
20142107$6,002,095$625,899$5,850iApproximate average salary by contribution assumption: employee only about $146,238 at 4% or $97,492 at 6%; with 50% employer match about $97,492 at 4% or $64,995 at 6%; with 100% employer match about $73,119 at 4% or $48,746 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-84$6,002,095$625,899$7,451iApproximate average salary by contribution assumption: employee only about $186,279 at 4% or $124,186 at 6%; with 50% employer match about $124,186 at 4% or $82,791 at 6%; with 100% employer match about $93,140 at 4% or $62,093 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-107---
20132124$5,701,920$650,823$5,249iApproximate average salary by contribution assumption: employee only about $131,214 at 4% or $87,476 at 6%; with 50% employer match about $87,476 at 4% or $58,317 at 6%; with 100% employer match about $65,607 at 4% or $43,738 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-124$5,701,920$650,823$5,249iApproximate average salary by contribution assumption: employee only about $131,214 at 4% or $87,476 at 6%; with 50% employer match about $87,476 at 4% or $58,317 at 6%; with 100% employer match about $65,607 at 4% or $43,738 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-101---
20122136$4,986,574$800,445$5,886iApproximate average salary by contribution assumption: employee only about $147,141 at 4% or $98,094 at 6%; with 50% employer match about $98,094 at 4% or $65,396 at 6%; with 100% employer match about $73,570 at 4% or $49,047 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-136$4,986,574$800,445$5,886iApproximate average salary by contribution assumption: employee only about $147,141 at 4% or $98,094 at 6%; with 50% employer match about $98,094 at 4% or $65,396 at 6%; with 100% employer match about $73,570 at 4% or $49,047 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-101---
20112153$4,356,911$720,201$4,707iApproximate average salary by contribution assumption: employee only about $117,680 at 4% or $78,453 at 6%; with 50% employer match about $78,453 at 4% or $52,302 at 6%; with 100% employer match about $58,840 at 4% or $39,227 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-153$4,356,911$720,201$4,707iApproximate average salary by contribution assumption: employee only about $117,680 at 4% or $78,453 at 6%; with 50% employer match about $78,453 at 4% or $52,302 at 6%; with 100% employer match about $58,840 at 4% or $39,227 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-121---
20102156$4,397,549$558,890$3,583iApproximate average salary by contribution assumption: employee only about $89,566 at 4% or $59,710 at 6%; with 50% employer match about $59,710 at 4% or $39,807 at 6%; with 100% employer match about $44,783 at 4% or $29,855 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-156$4,397,549$558,890$3,583iApproximate average salary by contribution assumption: employee only about $89,566 at 4% or $59,710 at 6%; with 50% employer match about $59,710 at 4% or $39,807 at 6%; with 100% employer match about $44,783 at 4% or $29,855 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-125---
20092149$3,592,314$597,183$4,008iApproximate average salary by contribution assumption: employee only about $100,198 at 4% or $66,799 at 6%; with 50% employer match about $66,799 at 4% or $44,533 at 6%; with 100% employer match about $50,099 at 4% or $33,399 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-149$3,592,314$597,183$4,008iApproximate average salary by contribution assumption: employee only about $100,198 at 4% or $66,799 at 6%; with 50% employer match about $66,799 at 4% or $44,533 at 6%; with 100% employer match about $50,099 at 4% or $33,399 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-124---
20082166$2,454,149$581,243$3,501iApproximate average salary by contribution assumption: employee only about $87,537 at 4% or $58,358 at 6%; with 50% employer match about $58,358 at 4% or $38,905 at 6%; with 100% employer match about $43,768 at 4% or $29,179 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-166$2,454,149$581,243$3,501iApproximate average salary by contribution assumption: employee only about $87,537 at 4% or $58,358 at 6%; with 50% employer match about $58,358 at 4% or $38,905 at 6%; with 100% employer match about $43,768 at 4% or $29,179 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-161---
20072161$3,589,813$660,356$4,102iApproximate average salary by contribution assumption: employee only about $102,540 at 4% or $68,360 at 6%; with 50% employer match about $68,360 at 4% or $45,573 at 6%; with 100% employer match about $51,270 at 4% or $34,180 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-161$3,589,813$660,356$4,102iApproximate average salary by contribution assumption: employee only about $102,540 at 4% or $68,360 at 6%; with 50% employer match about $68,360 at 4% or $45,573 at 6%; with 100% employer match about $51,270 at 4% or $34,180 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-161---
20062158$2,748,013$561,767$3,555iApproximate average salary by contribution assumption: employee only about $88,887 at 4% or $59,258 at 6%; with 50% employer match about $59,258 at 4% or $39,505 at 6%; with 100% employer match about $44,444 at 4% or $29,629 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-148$2,748,013$561,767$3,796iApproximate average salary by contribution assumption: employee only about $94,893 at 4% or $63,262 at 6%; with 50% employer match about $63,262 at 4% or $42,175 at 6%; with 100% employer match about $47,447 at 4% or $31,631 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLAN-158---
20052156$2,140,638$526,264$3,373iApproximate average salary by contribution assumption: employee only about $84,337 at 4% or $56,225 at 6%; with 50% employer match about $56,225 at 4% or $37,483 at 6%; with 100% employer match about $42,169 at 4% or $28,112 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-156$2,140,638$526,264$3,373iApproximate average salary by contribution assumption: employee only about $84,337 at 4% or $56,225 at 6%; with 50% employer match about $56,225 at 4% or $37,483 at 6%; with 100% employer match about $42,169 at 4% or $28,112 at 6%.
CONSTRUCTION TESTING & ENGINEERING, INC. WELFARE BENEFITS PLANCurrent138---
20041136$1,604,052$439,717$3,233iApproximate average salary by contribution assumption: employee only about $80,830 at 4% or $53,887 at 6%; with 50% employer match about $53,887 at 4% or $35,925 at 6%; with 100% employer match about $40,415 at 4% or $26,943 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-136$1,604,052$439,717$3,233iApproximate average salary by contribution assumption: employee only about $80,830 at 4% or $53,887 at 6%; with 50% employer match about $53,887 at 4% or $35,925 at 6%; with 100% employer match about $40,415 at 4% or $26,943 at 6%.
2003182$0$0-
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-82---
2002170$682,419$318,096$4,544iApproximate average salary by contribution assumption: employee only about $113,606 at 4% or $75,737 at 6%; with 50% employer match about $75,737 at 4% or $50,491 at 6%; with 100% employer match about $56,803 at 4% or $37,869 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-70$682,419$318,096$4,544iApproximate average salary by contribution assumption: employee only about $113,606 at 4% or $75,737 at 6%; with 50% employer match about $75,737 at 4% or $50,491 at 6%; with 100% employer match about $56,803 at 4% or $37,869 at 6%.
20011168$0$0-
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-168---
20001161$0$0-
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-161---
1999153$443,746$62,769$1,184iApproximate average salary by contribution assumption: employee only about $29,608 at 4% or $19,739 at 6%; with 50% employer match about $19,739 at 4% or $13,159 at 6%; with 100% employer match about $14,804 at 4% or $9,869 at 6%.
Construction Testing & Engineering Inc. 401K Retirement Savings Plan-53$443,746$62,769$1,184iApproximate average salary by contribution assumption: employee only about $29,608 at 4% or $19,739 at 6%; with 50% employer match about $19,739 at 4% or $13,159 at 6%; with 100% employer match about $14,804 at 4% or $9,869 at 6%.
Schedule Details

Schedule A

Row 1
Filing Id
84037116058537
Form Id
77520496
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
5030377116058030004
Ins Broker 01 Name
JOHN BURNHAM INSURANCE SERVICES
Ins Broker 01 Street Addr
750 B STREET, SUITE 2400
Ins Broker 01 City
SAN DIEGO
Ins Broker 01 State
CA
Ins Broker 01 ZIP Code
92101
Ins Broker Comm Pd 01 Amount
$6,110
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 2
Filing Id
84037116058537
Form Id
77520497
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
5030377116058030005
Ins Broker 01 Name
JOHN BURNHAM INSURANCE SERVICES
Ins Broker 01 Street Addr
750 B STREET, SUITE 2400
Ins Broker 01 City
SAN DIEGO
Ins Broker 01 State
CA
Ins Broker 01 ZIP Code
92101
Ins Broker Comm Pd 01 Amount
$334
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 3
Filing Id
84037116058537
Form Id
77520494
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
5030377116058030002
Ins Broker 01 Name
JOHN BURNHAM INSURANCE SERVICES
Ins Broker 01 Street Addr
750 B STREET, SUITE 2400
Ins Broker 01 City
SAN DIEGO
Ins Broker 01 State
CA
Ins Broker 01 ZIP Code
92101
Ins Broker Comm Pd 01 Amount
$1,737
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 4
Filing Id
84037116058537
Form Id
77520495
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
5030377116058030003
Ins Broker 01 Name
JOHN BURNHAM INSURANCE SERVICES
Ins Broker 01 Street Addr
750 B STREET, SUITE 2400
Ins Broker 01 City
SAN DIEGO
Ins Broker 01 State
CA
Ins Broker 01 ZIP Code
92101
Ins Broker Comm Pd 01 Amount
$571
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 5
Filing Id
84037116058537
Form Id
77520494
Page Id
2
Page Seq
0
Page Row Num
2
Row Num
1
Image Form Id
5030377116058030002
Ins Broker 01 Name
CONSOLIDATED FINANCIAL
Ins Broker 01 Street Addr
510 W. 6TH STREET
Ins Broker 01 City
LOS ANGELES
Ins Broker 01 State
CA
Ins Broker 01 ZIP Code
90014
Ins Broker Comm Pd 01 Amount
$9
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 6
Ins Carrier Name: VISION PLAN OF AMERICA
Filing Id
84037116058537
Form Id
77520497
Schedule A EIN
93-0997190
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2005-09-01
Schedule A Tax Period
20060831
Ins Carrier Name
VISION PLAN OF AMERICA
Ins Carrier EIN
95-3998493
Ins Carrier Naic Code
00000
Ins Contract Num
862
Ins Prsn Covered End of year Count
35
Ins Policy From Date
2005-09-01
Ins Policy To Date
2006-08-31
Ins Broker Comm Total Amount
$334
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
$2,157
Wlfr Acquis Cost Amount
$0
Row 7
Ins Carrier Name: GUARDIAN
Filing Id
84037116058537
Form Id
77520494
Schedule A EIN
93-0997190
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2005-09-01
Schedule A Tax Period
20060831
Ins Carrier Name
GUARDIAN
Ins Carrier EIN
13-5123390
Ins Carrier Naic Code
64246
Ins Contract Num
00363006
Ins Prsn Covered End of year Count
78
Ins Policy From Date
2005-09-01
Ins Policy To Date
2006-03-31
Ins Broker Comm Total Amount
$1,746
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
$21,903
Wlfr Acquis Cost Amount
$0
Row 8
Ins Carrier Name: HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
Filing Id
84037116058537
Form Id
77520495
Schedule A EIN
93-0997190
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2005-09-01
Schedule A Tax Period
20060831
Ins Carrier Name
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
Ins Carrier EIN
06-0838648
Ins Carrier Naic Code
70815
Ins Contract Num
707596
Ins Prsn Covered End of year Count
138
Ins Policy From Date
2005-09-01
Ins Policy To Date
2006-08-31
Ins Broker Comm Total Amount
$571
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
DM
Wlfr Type Bnft Oth Text
ACCIDENTAL DEATH & DISMEMBERMENT
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
$3,809
Wlfr Acquis Cost Amount
$0
Row 9
Ins Carrier Name: KAISER PERMANENTE
Filing Id
84037116058537
Form Id
77520496
Schedule A EIN
93-0997190
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2005-09-01
Schedule A Tax Period
20060831
Ins Carrier Name
KAISER PERMANENTE
Ins Carrier EIN
94-1340523
Ins Carrier Naic Code
00000
Ins Contract Num
225925
Ins Prsn Covered End of year Count
35
Ins Policy From Date
2005-09-01
Ins Policy To Date
2006-03-31
Ins Broker Comm Total Amount
$6,110
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
AJ
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
$119,060
Wlfr Acquis Cost Amount
$0