401k Plan data: GROUP VOLUNTARY SHORT TERM DISABILITY plan

GROUP VOLUNTARY SHORT TERM DISABILITY 401k Plan overview

Plan Name	GROUP VOLUNTARY SHORT TERM DISABILITY
Plan identification number	508

GROUP VOLUNTARY SHORT TERM DISABILITY Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness) 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

PLASTIC SUPPLIERS, INC. has sponsored the creation of one or more 401k plans.

Company Name: PLASTIC SUPPLIERS, INC.

Employer identification number (EIN): 270719518

NAIC Classification: 326100

Additional information about PLASTIC SUPPLIERS, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1976-02-18

Company Identification Number: 0003864606

Legal Registered Office Address: 2400 MARILYN LN

COLUMBUS
United States of America (USA)
43219

More information about PLASTIC SUPPLIERS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP VOLUNTARY SHORT TERM DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
508 2021-01-01
508 2020-01-01
508 2019-01-01
508 2018-01-01 MICHAEL DUFRAYNE MICHAEL DUFRAYNE 2019-07-23
508 2017-01-01 MICHAEL DUFRAYNE

Plan Statistics for GROUP VOLUNTARY SHORT TERM DISABILITY

401k plan membership statisitcs for GROUP VOLUNTARY SHORT TERM DISABILITY

Measure Date Value
2021: GROUP VOLUNTARY SHORT TERM DISABILITY 2021 401k membership
Total participants, beginning-of-year 2021-01-01 58
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 48
Total of all active and inactive participants 2021-01-01 48
Total participants 2021-01-01 48
2020: GROUP VOLUNTARY SHORT TERM DISABILITY 2020 401k membership
Total participants, beginning-of-year 2020-01-01 77
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 58
Total of all active and inactive participants 2020-01-01 58
Total participants 2020-01-01 58
2019: GROUP VOLUNTARY SHORT TERM DISABILITY 2019 401k membership
Total participants, beginning-of-year 2019-01-01 64
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 77
Total of all active and inactive participants 2019-01-01 77
Total participants 2019-01-01 77
2018: GROUP VOLUNTARY SHORT TERM DISABILITY 2018 401k membership
Total participants, beginning-of-year 2018-01-01 75
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 64
Total of all active and inactive participants 2018-01-01 64
Total participants 2018-01-01 64
2017: GROUP VOLUNTARY SHORT TERM DISABILITY 2017 401k membership
Total participants, beginning-of-year 2017-01-01 56
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 75
Total of all active and inactive participants 2017-01-01 75
Total participants 2017-01-01 75

Measure	Date	Value
2021: GROUP VOLUNTARY SHORT TERM DISABILITY 2021 401k membership
Total participants, beginning-of-year	2021-01-01	58
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	48
Total of all active and inactive participants	2021-01-01	48
Total participants	2021-01-01	48
2020: GROUP VOLUNTARY SHORT TERM DISABILITY 2020 401k membership
Total participants, beginning-of-year	2020-01-01	77
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	58
Total of all active and inactive participants	2020-01-01	58
Total participants	2020-01-01	58
2019: GROUP VOLUNTARY SHORT TERM DISABILITY 2019 401k membership
Total participants, beginning-of-year	2019-01-01	64
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	77
Total of all active and inactive participants	2019-01-01	77
Total participants	2019-01-01	77
2018: GROUP VOLUNTARY SHORT TERM DISABILITY 2018 401k membership
Total participants, beginning-of-year	2018-01-01	75
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	64
Total of all active and inactive participants	2018-01-01	64
Total participants	2018-01-01	64
2017: GROUP VOLUNTARY SHORT TERM DISABILITY 2017 401k membership
Total participants, beginning-of-year	2017-01-01	56
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	75
Total of all active and inactive participants	2017-01-01	75
Total participants	2017-01-01	75

Form 5500 Responses for GROUP VOLUNTARY SHORT TERM DISABILITY

2021: GROUP VOLUNTARY SHORT TERM DISABILITY 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	Yes
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: GROUP VOLUNTARY SHORT TERM DISABILITY 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: GROUP VOLUNTARY SHORT TERM DISABILITY 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: GROUP VOLUNTARY SHORT TERM DISABILITY 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: GROUP VOLUNTARY SHORT TERM DISABILITY 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000ARV7

Policy instance

Insurance contract or identification number	G000ARV7
Number of Individuals Covered	48
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,379
Total amount of fees paid to insurance company	USD $483
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $13,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,379
Amount paid for insurance broker fees	483
Additional information about fees paid to insurance broker	SERVICE
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000ARV7

Policy instance

Insurance contract or identification number	G000ARV7
Number of Individuals Covered	58
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,380
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $13,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,380
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SERVICE
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000ARV7

Policy instance

Insurance contract or identification number	G000ARV7
Number of Individuals Covered	77
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,366
Total amount of fees paid to insurance company	USD $510
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $13,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,366
Amount paid for insurance broker fees	510
Additional information about fees paid to insurance broker	SERVICE
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000ARV7

Policy instance

Insurance contract or identification number	G000ARV7
Number of Individuals Covered	64
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,458
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $14,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,458
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SERVICE
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000ARV7

Policy instance

Insurance contract or identification number	G000ARV7
Number of Individuals Covered	75
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,331
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $13,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,331
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SERVICE
Insurance broker organization code?	3
Insurance broker name	CLEARPATH BENEFIT ADVISORS LLC

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Company Name:	PLASTIC SUPPLIERS, INC.
Employer identification number (EIN):	270719518
NAIC Classification:	326100

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1976-02-18
Company Identification Number:	0003864606
Legal Registered Office Address:	2400 MARILYN LN COLUMBUS United States of America (USA) 43219