401k Plan data: HEALTH AND WELFARE PLAN

HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 401k Plan overview

Plan Name	HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES
Plan identification number	501

HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES Benefits

401k Plan Type

Welfare Benefit

Plan Features/Benefits

Health (other than dental or vision)
Life insurance
Dental
Temporary disability (accident and sickness)
Long-term disability cover
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.
Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

VISCOFAN COLLAGEN USA INC. has sponsored the creation of one or more 401k plans.

Company Name: VISCOFAN COLLAGEN USA INC.

Employer identification number (EIN): 223455324

NAIC Classification: 339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-04-01
501 2019-04-01
501 2018-04-01
501 2017-04-01 ROSEANN SALERNO
501 2016-04-01 ROSEANN SALERNO
501 2015-04-01 ROSEANN SALERNO
501 2014-04-01 ROSEANN SALERNO
501 2013-04-01 ROSEANN SALERNO
501 2011-04-01 ROSEANN SALERNO
501 2010-04-01 ROSEANN SALERNO
501 2009-04-01 2010-12-23
501 2009-04-01 JOHN STERBINSKY
501 2009-04-01 2010-12-23

Plan Statistics for HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES

401k plan membership statisitcs for HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES

Measure Date Value
2020: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2020 401k membership
Total participants, beginning-of-year 2020-04-01 62
Total number of active participants reported on line 7a of the Form 5500 2020-04-01 47
Total of all active and inactive participants 2020-04-01 47
Total participants 2020-04-01 47
2019: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2019 401k membership
Total participants, beginning-of-year 2019-04-01 74
Total number of active participants reported on line 7a of the Form 5500 2019-04-01 62
Total of all active and inactive participants 2019-04-01 62
Total participants 2019-04-01 62
2018: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2018 401k membership
Total participants, beginning-of-year 2018-04-01 77
Total number of active participants reported on line 7a of the Form 5500 2018-04-01 75
Total of all active and inactive participants 2018-04-01 75
Total participants 2018-04-01 75
2017: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2017 401k membership
Total participants, beginning-of-year 2017-04-01 67
Total number of active participants reported on line 7a of the Form 5500 2017-04-01 77
Total of all active and inactive participants 2017-04-01 77
Total participants 2017-04-01 77
2016: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2016 401k membership
Total participants, beginning-of-year 2016-04-01 70
Total number of active participants reported on line 7a of the Form 5500 2016-04-01 67
Total of all active and inactive participants 2016-04-01 67
Total participants 2016-04-01 67
2015: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2015 401k membership
Total participants, beginning-of-year 2015-04-01 73
Total number of active participants reported on line 7a of the Form 5500 2015-04-01 70
Total of all active and inactive participants 2015-04-01 70
Total participants 2015-04-01 0
2014: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2014 401k membership
Total participants, beginning-of-year 2014-04-01 165
Total number of active participants reported on line 7a of the Form 5500 2014-04-01 164
Number of retired or separated participants receiving benefits 2014-04-01 0
Number of other retired or separated participants entitled to future benefits 2014-04-01 0
Total of all active and inactive participants 2014-04-01 164
2013: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2013 401k membership
Total participants, beginning-of-year 2013-04-01 170
Total number of active participants reported on line 7a of the Form 5500 2013-04-01 165
Number of retired or separated participants receiving benefits 2013-04-01 0
Number of other retired or separated participants entitled to future benefits 2013-04-01 0
Total of all active and inactive participants 2013-04-01 165
2011: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2011 401k membership
Total participants, beginning-of-year 2011-04-01 69
Total number of active participants reported on line 7a of the Form 5500 2011-04-01 75
Number of retired or separated participants receiving benefits 2011-04-01 0
Number of other retired or separated participants entitled to future benefits 2011-04-01 0
Total of all active and inactive participants 2011-04-01 75
2010: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2010 401k membership
Total participants, beginning-of-year 2010-04-01 59
Total number of active participants reported on line 7a of the Form 5500 2010-04-01 69
Number of retired or separated participants receiving benefits 2010-04-01 0
Number of other retired or separated participants entitled to future benefits 2010-04-01 0
Total of all active and inactive participants 2010-04-01 69
2009: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2009 401k membership
Total participants, beginning-of-year 2009-04-01 61
Total number of active participants reported on line 7a of the Form 5500 2009-04-01 60
Number of retired or separated participants receiving benefits 2009-04-01 63
Number of other retired or separated participants entitled to future benefits 2009-04-01 0
Total of all active and inactive participants 2009-04-01 123

Measure	Date	Value
2020: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2020 401k membership
Total participants, beginning-of-year	2020-04-01	62
Total number of active participants reported on line 7a of the Form 5500	2020-04-01	47
Total of all active and inactive participants	2020-04-01	47
Total participants	2020-04-01	47
2019: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2019 401k membership
Total participants, beginning-of-year	2019-04-01	74
Total number of active participants reported on line 7a of the Form 5500	2019-04-01	62
Total of all active and inactive participants	2019-04-01	62
Total participants	2019-04-01	62
2018: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2018 401k membership
Total participants, beginning-of-year	2018-04-01	77
Total number of active participants reported on line 7a of the Form 5500	2018-04-01	75
Total of all active and inactive participants	2018-04-01	75
Total participants	2018-04-01	75
2017: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2017 401k membership
Total participants, beginning-of-year	2017-04-01	67
Total number of active participants reported on line 7a of the Form 5500	2017-04-01	77
Total of all active and inactive participants	2017-04-01	77
Total participants	2017-04-01	77
2016: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2016 401k membership
Total participants, beginning-of-year	2016-04-01	70
Total number of active participants reported on line 7a of the Form 5500	2016-04-01	67
Total of all active and inactive participants	2016-04-01	67
Total participants	2016-04-01	67
2015: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2015 401k membership
Total participants, beginning-of-year	2015-04-01	73
Total number of active participants reported on line 7a of the Form 5500	2015-04-01	70
Total of all active and inactive participants	2015-04-01	70
Total participants	2015-04-01	0
2014: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2014 401k membership
Total participants, beginning-of-year	2014-04-01	165
Total number of active participants reported on line 7a of the Form 5500	2014-04-01	164
Number of retired or separated participants receiving benefits	2014-04-01	0
Number of other retired or separated participants entitled to future benefits	2014-04-01	0
Total of all active and inactive participants	2014-04-01	164
2013: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2013 401k membership
Total participants, beginning-of-year	2013-04-01	170
Total number of active participants reported on line 7a of the Form 5500	2013-04-01	165
Number of retired or separated participants receiving benefits	2013-04-01	0
Number of other retired or separated participants entitled to future benefits	2013-04-01	0
Total of all active and inactive participants	2013-04-01	165
2011: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2011 401k membership
Total participants, beginning-of-year	2011-04-01	69
Total number of active participants reported on line 7a of the Form 5500	2011-04-01	75
Number of retired or separated participants receiving benefits	2011-04-01	0
Number of other retired or separated participants entitled to future benefits	2011-04-01	0
Total of all active and inactive participants	2011-04-01	75
2010: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2010 401k membership
Total participants, beginning-of-year	2010-04-01	59
Total number of active participants reported on line 7a of the Form 5500	2010-04-01	69
Number of retired or separated participants receiving benefits	2010-04-01	0
Number of other retired or separated participants entitled to future benefits	2010-04-01	0
Total of all active and inactive participants	2010-04-01	69
2009: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2009 401k membership
Total participants, beginning-of-year	2009-04-01	61
Total number of active participants reported on line 7a of the Form 5500	2009-04-01	60
Number of retired or separated participants receiving benefits	2009-04-01	63
Number of other retired or separated participants entitled to future benefits	2009-04-01	0
Total of all active and inactive participants	2009-04-01	123

Form 5500 Responses for HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES

2020: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2020 form 5500 responses
2020-04-01	Type of plan entity	Single employer plan
2020-04-01	Plan funding arrangement – Insurance	Yes
2020-04-01	Plan benefit arrangement – Insurance	Yes
2019: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2019 form 5500 responses
2019-04-01	Type of plan entity	Single employer plan
2019-04-01	Plan funding arrangement – Insurance	Yes
2019-04-01	Plan benefit arrangement – Insurance	Yes
2018: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2018 form 5500 responses
2018-04-01	Type of plan entity	Single employer plan
2018-04-01	Plan funding arrangement – Insurance	Yes
2018-04-01	Plan benefit arrangement – Insurance	Yes
2017: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2017 form 5500 responses
2017-04-01	Type of plan entity	Single employer plan
2017-04-01	Plan funding arrangement – Insurance	Yes
2017-04-01	Plan benefit arrangement – Insurance	Yes
2016: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	Plan funding arrangement – Insurance	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes
2015: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2015 form 5500 responses
2015-04-01	Type of plan entity	Single employer plan
2015-04-01	Plan funding arrangement – Insurance	Yes
2015-04-01	Plan benefit arrangement – Insurance	Yes
2014: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2014 form 5500 responses
2014-04-01	Type of plan entity	Single employer plan
2014-04-01	Submission has been amended	No
2014-04-01	This submission is the final filing	No
2014-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-04-01	Plan is a collectively bargained plan	No
2014-04-01	Plan funding arrangement – Insurance	Yes
2014-04-01	Plan benefit arrangement – Insurance	Yes
2013: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2013 form 5500 responses
2013-04-01	Type of plan entity	Single employer plan
2013-04-01	Submission has been amended	No
2013-04-01	This submission is the final filing	No
2013-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-04-01	Plan is a collectively bargained plan	No
2013-04-01	Plan funding arrangement – Insurance	Yes
2013-04-01	Plan benefit arrangement – Insurance	Yes
2011: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2011 form 5500 responses
2011-04-01	Type of plan entity	Single employer plan
2011-04-01	Submission has been amended	No
2011-04-01	This submission is the final filing	No
2011-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-04-01	Plan is a collectively bargained plan	No
2011-04-01	Plan funding arrangement – Insurance	Yes
2011-04-01	Plan benefit arrangement – Insurance	Yes
2010: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2010 form 5500 responses
2010-04-01	Type of plan entity	Single employer plan
2010-04-01	Submission has been amended	No
2010-04-01	This submission is the final filing	No
2010-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-04-01	Plan is a collectively bargained plan	No
2010-04-01	Plan funding arrangement – Insurance	Yes
2010-04-01	Plan benefit arrangement – Insurance	Yes
2009: HEALTH AND WELFARE PLAN - SALARIED EMPLOYEES 2009 form 5500 responses
2009-04-01	Type of plan entity	Single employer plan
2009-04-01	Submission has been amended	Yes
2009-04-01	This submission is the final filing	No
2009-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-04-01	Plan is a collectively bargained plan	No
2009-04-01	Plan funding arrangement – Insurance	Yes
2009-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )

Policy contract number

89365

Policy instance

Insurance contract or identification number	89365
Number of Individuals Covered	47
Insurance policy start date	2020-04-01
Insurance policy end date	2021-03-31
Total amount of commissions paid to insurance broker	USD $28,383
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $772,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $28,383
Insurance broker organization code?	3

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )

Policy contract number

89365

Policy instance

Insurance contract or identification number	89365
Number of Individuals Covered	62
Insurance policy start date	2019-04-01
Insurance policy end date	2020-03-31
Total amount of commissions paid to insurance broker	USD $12,825
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $840,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,825
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

860757G

Policy instance

Insurance contract or identification number	860757G
Number of Individuals Covered	62
Insurance policy start date	2019-04-01
Insurance policy end date	2020-03-31
Total amount of commissions paid to insurance broker	USD $12,710
Total amount of fees paid to insurance company	USD $7,989
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D/BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $127,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,710
Amount paid for insurance broker fees	6540
Additional information about fees paid to insurance broker	FEES PAID
Insurance broker organization code?	3

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )

Policy contract number

89365

Policy instance

Insurance contract or identification number	89365
Number of Individuals Covered	75
Insurance policy start date	2018-04-01
Insurance policy end date	2019-03-31
Total amount of commissions paid to insurance broker	USD $13,191
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $928,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,191
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

860757G

Policy instance

Insurance contract or identification number	860757G
Number of Individuals Covered	75
Insurance policy start date	2018-04-01
Insurance policy end date	2019-03-31
Total amount of commissions paid to insurance broker	USD $18,500
Total amount of fees paid to insurance company	USD $11,105
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D/BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $148,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1541
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $18,500

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )

Policy contract number

89365

Policy instance

Insurance contract or identification number	89365
Number of Individuals Covered	77
Insurance policy start date	2017-04-01
Insurance policy end date	2018-03-31
Total amount of commissions paid to insurance broker	USD $13,706
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $865,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,706
Insurance broker organization code?	3
Insurance broker name	PROFESSIONAL GROUP PLANS INC.

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

860757G

Policy instance

Insurance contract or identification number	860757G
Number of Individuals Covered	77
Insurance policy start date	2017-04-01
Insurance policy end date	2018-03-31
Total amount of commissions paid to insurance broker	USD $13,391
Total amount of fees paid to insurance company	USD $6,900
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D/BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $155,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,391
Amount paid for insurance broker fees	6900
Additional information about fees paid to insurance broker	FEES PAID
Insurance broker organization code?	3
Insurance broker name	PROFESSIONAL GROUP PLANS INC.

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Company Name:	VISCOFAN COLLAGEN USA INC.
Employer identification number (EIN):	223455324
NAIC Classification:	339900