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GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 401k Plan overview

Plan NameGROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT
Plan identification number 508

GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

HARTLEY & PARKER LIMITED, INC. has sponsored the creation of one or more 401k plans.

Company Name:HARTLEY & PARKER LIMITED, INC.
Employer identification number (EIN):060384867
NAIC Classification:424800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5082023-01-01JANELLE DUBSKY2024-07-08
5082022-01-01JANELLE DUBSKY2023-08-22
5082022-01-01
5082022-01-01DAVID ROSENBERG
5082021-01-01
5082021-01-01MIKE BYLO
5082020-01-01
5082019-01-01
5082018-01-01
5082017-01-01MIKE BYLO
5082016-01-01MIKE BYLO
5082015-01-01MIKE BYLO
5082014-01-01MIKE BYLO
5082013-01-01MIKE BYLO
5082012-01-01MIKE BYLO
5082011-01-01MIKE BYLO
5082009-01-01MIKE BYLO

Form 5500 Responses for GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT

2023: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006089
Policy instance 1
Insurance contract or identification numberAL00006089
Number of Individuals Covered181
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $13,381
Total amount of fees paid to insurance companyUSD $1,538
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $82,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006089
Policy instance 1
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006089
Policy instance 1
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006089
Policy instance 1
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006089
Policy instance 1
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006089
Policy instance 1
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006089
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601147
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601147
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601147
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601147
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601147
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601147
Policy instance 1

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