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EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 401k Plan overview

Plan NameEMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC
Plan identification number 502

EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Supplemental unemployment
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Apprenticeship and training
  • Scholarship (funded)
  • Other welfare benefit cover
  • Collectively bargained welfare benefit arrangement under Code section 419A(f)(5).

401k Sponsoring company profile

CONSTELLIUM ROLLED PRODUCTS RAVENSWOOD L has sponsored the creation of one or more 401k plans.

Company Name:CONSTELLIUM ROLLED PRODUCTS RAVENSWOOD L
Employer identification number (EIN):200843018
NAIC Classification:331400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01LISA DAIGLE2023-10-11
5022021-01-01SCOTT KERMODE2022-10-06
5022020-01-01SCOTT KERMODE2021-10-15
5022019-01-01SCOTT KERMODE2020-10-15
5022018-01-01
5022017-01-01SCOTT KERMODE
5022016-01-01SCOTT KERMODE
5022015-01-01TISHA SCHMIDT
5022014-01-01TISHA SCHMDIT
5022013-01-01TISHA SCHMDIT
5022012-01-01TISHA SCHMIDT TISHA SCHMIDT2013-10-15
5022011-01-01TISHA SCHMIDT
5022009-01-01BILL PITCHFORD BILL PITCHFORD2010-07-29

Plan Statistics for EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC

401k plan membership statisitcs for EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC

Measure Date Value
2022: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2022 401k membership
Total participants, beginning-of-year2022-01-011,895
Total number of active participants reported on line 7a of the Form 55002022-01-01834
Number of retired or separated participants receiving benefits2022-01-011,111
Total of all active and inactive participants2022-01-011,945
2021: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2021 401k membership
Total participants, beginning-of-year2021-01-011,907
Total number of active participants reported on line 7a of the Form 55002021-01-01784
Number of retired or separated participants receiving benefits2021-01-011,111
Total of all active and inactive participants2021-01-011,895
2020: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2020 401k membership
Total participants, beginning-of-year2020-01-011,923
Total number of active participants reported on line 7a of the Form 55002020-01-01784
Number of retired or separated participants receiving benefits2020-01-011,123
Total of all active and inactive participants2020-01-011,907
2019: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2019 401k membership
Total participants, beginning-of-year2019-01-012,018
Total number of active participants reported on line 7a of the Form 55002019-01-01855
Number of retired or separated participants receiving benefits2019-01-011,068
Total of all active and inactive participants2019-01-011,923
2018: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2018 401k membership
Total participants, beginning-of-year2018-01-011,935
Total number of active participants reported on line 7a of the Form 55002018-01-01839
Number of retired or separated participants receiving benefits2018-01-011,179
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-012,018
2017: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2017 401k membership
Total participants, beginning-of-year2017-01-011,964
Total number of active participants reported on line 7a of the Form 55002017-01-01827
Number of retired or separated participants receiving benefits2017-01-011,108
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-011,935
2016: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2016 401k membership
Total participants, beginning-of-year2016-01-011,900
Total number of active participants reported on line 7a of the Form 55002016-01-01845
Number of retired or separated participants receiving benefits2016-01-011,119
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-011,964
2015: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2015 401k membership
Total participants, beginning-of-year2015-01-011,890
Total number of active participants reported on line 7a of the Form 55002015-01-01796
Number of retired or separated participants receiving benefits2015-01-011,123
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-011,919
2014: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2014 401k membership
Total participants, beginning-of-year2014-01-011,781
Total number of active participants reported on line 7a of the Form 55002014-01-01732
Number of retired or separated participants receiving benefits2014-01-011,068
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-011,800
2013: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2013 401k membership
Total participants, beginning-of-year2013-01-011,814
Total number of active participants reported on line 7a of the Form 55002013-01-01721
Number of retired or separated participants receiving benefits2013-01-011,128
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-011,849
2012: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2012 401k membership
Total participants, beginning-of-year2012-01-011,830
Total number of active participants reported on line 7a of the Form 55002012-01-01675
Number of retired or separated participants receiving benefits2012-01-011,224
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-011,899
2011: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2011 401k membership
Total participants, beginning-of-year2011-01-011,810
Total number of active participants reported on line 7a of the Form 55002011-01-01654
Number of retired or separated participants receiving benefits2011-01-011,121
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-011,775
2009: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2009 401k membership
Total participants, beginning-of-year2009-01-011,770
Total number of active participants reported on line 7a of the Form 55002009-01-01690
Number of retired or separated participants receiving benefits2009-01-011,000
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-011,690

Form 5500 Responses for EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC

2022: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: EMPLOYEES' GROUP BENEFITS PLAN FOR ACTIVE AND RETIRED PRODUCTION AND MAINTENANCE EMPLOYEES OF CONSTELLIUM ROLLED PROD. RAVENSWOOD, LLC 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53261
Policy instance 2
Insurance contract or identification number53261
Number of Individuals Covered1945
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $19,965
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOL LIFE, VOL AD&D, VOL DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $605,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,965
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0216446
Policy instance 1
Insurance contract or identification number0216446
Number of Individuals Covered1945
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,762
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $346,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5762
Additional information about fees paid to insurance brokerSUPPLEMENTAL AND NON-MONETARY COMPENSATION
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53261
Policy instance 2
Insurance contract or identification number53261
Number of Individuals Covered1895
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $7,896
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $316,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,896
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0216446
Policy instance 1
Insurance contract or identification number0216446
Number of Individuals Covered1895
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,163
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $298,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4163
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION/NON-MONETARY COMPENSATION
Insurance broker organization code?3
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract numberESL100108200
Policy instance 3
Insurance contract or identification numberESL100108200
Number of Individuals Covered1907
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $502,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53261
Policy instance 2
Insurance contract or identification number53261
Number of Individuals Covered1907
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $328,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0216446
Policy instance 1
Insurance contract or identification number0216446
Number of Individuals Covered1907
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $271,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract numberESL100108200
Policy instance 3
Insurance contract or identification numberESL100108200
Number of Individuals Covered1923
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $482,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53261
Policy instance 2
Insurance contract or identification number53261
Number of Individuals Covered1923
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $231,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0216446
Policy instance 1
Insurance contract or identification number0216446
Number of Individuals Covered1923
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $289,846
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00460785
Policy instance 1
Insurance contract or identification number00460785
Number of Individuals Covered2018
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $51,693
Total amount of fees paid to insurance companyUSD $9,706
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,056,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,261
Amount paid for insurance broker fees9706
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00460785
Policy instance 1
Insurance contract or identification number00460785
Number of Individuals Covered1935
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $48,270
Total amount of fees paid to insurance companyUSD $17,021
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $876,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,144
Amount paid for insurance broker fees15919
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00460785*
Policy instance 1
Insurance contract or identification number00460785*
Number of Individuals Covered1836
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $49,101
Total amount of fees paid to insurance companyUSD $19,572
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $804,952
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,265
Amount paid for insurance broker fees19572
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameKENT M GRATHWOHL
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00460785*
Policy instance 1
Insurance contract or identification number00460785*
Number of Individuals Covered1827
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $46,592
Total amount of fees paid to insurance companyUSD $11,813
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $766,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,592
Insurance broker organization code?3
Amount paid for insurance broker fees11813
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker nameGROUP ASSOCIATES INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141849*
Policy instance 1
Insurance contract or identification number0141849*
Number of Individuals Covered0
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $80
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $80
Insurance broker organization code?3
Insurance broker nameKENT GRATHWOHL
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141849*
Policy instance 1
Insurance contract or identification number0141849*
Number of Individuals Covered2458
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $20,333
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $664,533
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,333
Insurance broker organization code?3
Insurance broker nameGROUP ASSOCIATES INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141849*
Policy instance 1
Insurance contract or identification number0141849*
Number of Individuals Covered2511
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $24,906
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $700,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0141849
Policy instance 1
Insurance contract or identification number0141849
Number of Individuals Covered2624
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $15,403
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $616,022

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