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SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN 401k Plan overview

Plan NameSOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN
Plan identification number 502

SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

SOUTH JERSEY GLASS CO. INC. has sponsored the creation of one or more 401k plans.

Company Name:SOUTH JERSEY GLASS CO. INC.
Employer identification number (EIN):210699654
NAIC Classification:442291
NAIC Description:Window Treatment Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-06-15JODI TRIVELLINI2024-01-29

Plan Statistics for SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN

401k plan membership statisitcs for SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN

Measure Date Value
2022: SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-15125
Total number of active participants reported on line 7a of the Form 55002022-06-15177
Number of retired or separated participants receiving benefits2022-06-150
Number of other retired or separated participants entitled to future benefits2022-06-150
Total of all active and inactive participants2022-06-15177
Number of employers contributing to the scheme2022-06-150

Form 5500 Responses for SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN

2022: SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-06-15Type of plan entitySingle employer plan
2022-06-15First time form 5500 has been submittedYes
2022-06-15Plan funding arrangement – InsuranceYes
2022-06-15Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number8006O
Policy instance 1
Insurance contract or identification number8006O
Number of Individuals Covered108
Insurance policy start date2022-06-15
Insurance policy end date2023-06-14
Total amount of commissions paid to insurance brokerUSD $39,542
Total amount of fees paid to insurance companyUSD $8,261
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $846,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,542
Amount paid for insurance broker fees8261
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50021928
Policy instance 2
Insurance contract or identification number50021928
Number of Individuals Covered177
Insurance policy start date2022-06-15
Insurance policy end date2023-06-14
Total amount of commissions paid to insurance brokerUSD $1,049
Total amount of fees paid to insurance companyUSD $393
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,049
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES

Potentially related plans

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