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MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN 401k Plan overview

Plan NameMUTUAL OF OMAHA ER LIFE WITH AD&D PLAN
Plan identification number 504

MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

VISTA LIFE INNOVATIONS INC. has sponsored the creation of one or more 401k plans.

Company Name:VISTA LIFE INNOVATIONS INC.
Employer identification number (EIN):223106714
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042021-01-01HELEN BOSCH2022-03-16
5042020-01-01HELEN BOSCH2021-03-24

Plan Statistics for MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN

401k plan membership statisitcs for MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN

Measure Date Value
2021: MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01105
Total number of active participants reported on line 7a of the Form 55002021-01-0192
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0192
Number of employers contributing to the scheme2021-01-010
2020: MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01106
Total number of active participants reported on line 7a of the Form 55002020-01-01105
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01105
Number of employers contributing to the scheme2020-01-010

Form 5500 Responses for MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN

2021: MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN 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: MUTUAL OF OMAHA ER LIFE WITH AD&D PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ABUU
Policy instance 1
Insurance contract or identification numberGLUG0ABUU
Number of Individuals Covered92
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $400
Total amount of fees paid to insurance companyUSD $518
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $400
Amount paid for insurance broker fees518
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ABUU
Policy instance 1
Insurance contract or identification numberGLUG0ABUU
Number of Individuals Covered102
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $424
Total amount of fees paid to insurance companyUSD $262
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $283
Amount paid for insurance broker fees141
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3

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