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EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameEMPLOYEE BENEFIT PLAN
Plan identification number 501

EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

DELTA AUTOMOTIVE SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:DELTA AUTOMOTIVE SERVICES, INC.
Employer identification number (EIN):223647484
NAIC Classification:811110
NAIC Description: Automotive Mechanical and Electrical Repair and Maintenance

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01JULIE ROCCANOVA2024-06-25
5012022-01-01JULIE ROCCANOVA2023-03-29
5012021-01-01JULIE ROCCANOVA2022-02-28
5012020-01-01JULIE ROCCANOVA2021-08-10

Plan Statistics for EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN

Measure Date Value
2023: EMPLOYEE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01138
Total number of active participants reported on line 7a of the Form 55002023-01-01142
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01142
Number of employers contributing to the scheme2023-01-010
2022: EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01120
Total number of active participants reported on line 7a of the Form 55002022-01-01137
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01137
Number of employers contributing to the scheme2022-01-010
2021: EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01136
Total number of active participants reported on line 7a of the Form 55002021-01-01120
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 participants2021-01-01120
Number of employers contributing to the scheme2021-01-010
2020: EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01100
Total number of active participants reported on line 7a of the Form 55002020-01-01136
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 participants2020-01-01136
Number of employers contributing to the scheme2020-01-010

Form 5500 Responses for EMPLOYEE BENEFIT PLAN

2023: EMPLOYEE BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: EMPLOYEE BENEFIT PLAN 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: EMPLOYEE BENEFIT 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: EMPLOYEE BENEFIT 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

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number880466G
Policy instance 2
Insurance contract or identification number880466G
Number of Individuals Covered41
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $2,128
Total amount of fees paid to insurance companyUSD $842
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number942
Policy instance 1
Insurance contract or identification number942
Number of Individuals Covered143
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $3,300
Total amount of fees paid to insurance companyUSD $776
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number629568
Policy instance 4
Insurance contract or identification number629568
Number of Individuals Covered161
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,611
Total amount of fees paid to insurance companyUSD $68,112
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,193,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number629568
Policy instance 3
Insurance contract or identification number629568
Number of Individuals Covered164
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $7,336
Total amount of fees paid to insurance companyUSD $95,526
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,643,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number880466G
Policy instance 2
Insurance contract or identification number880466G
Number of Individuals Covered32
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,898
Total amount of fees paid to insurance companyUSD $196
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number942
Policy instance 1
Insurance contract or identification number942
Number of Individuals Covered137
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,803
Total amount of fees paid to insurance companyUSD $-476
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number629568
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number880466G
Policy instance 2
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number942
Policy instance 1
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number05Y5784
Policy instance 4
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number880466G
Policy instance 3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number000942
Policy instance 2
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 78026 )
Policy contract numberDA11853
Policy instance 1

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