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GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 401k Plan overview

Plan NameGROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC.
Plan identification number 501

GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

SURFACE COMBUSTION, INC. has sponsored the creation of one or more 401k plans.

Company Name:SURFACE COMBUSTION, INC.
Employer identification number (EIN):341568193
NAIC Classification:333900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01

Plan Statistics for GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC.

401k plan membership statisitcs for GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC.

Measure Date Value
2017: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2017 401k membership
Total participants, beginning-of-year2017-01-0197
Total number of active participants reported on line 7a of the Form 55002017-01-0192
Total of all active and inactive participants2017-01-0192
2016: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2016 401k membership
Total participants, beginning-of-year2016-01-01105
Total number of active participants reported on line 7a of the Form 55002016-01-0197
Total of all active and inactive participants2016-01-0197
2015: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2015 401k membership
Total participants, beginning-of-year2015-01-01108
Total number of active participants reported on line 7a of the Form 55002015-01-01105
Total of all active and inactive participants2015-01-01105
2014: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2014 401k membership
Total participants, beginning-of-year2014-01-01103
Total number of active participants reported on line 7a of the Form 55002014-01-01108
Total of all active and inactive participants2014-01-01108
2013: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2013 401k membership
Total participants, beginning-of-year2013-01-01103
Total number of active participants reported on line 7a of the Form 55002013-01-01103
Total of all active and inactive participants2013-01-01103

Form 5500 Responses for GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC.

2017: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: GROUP MEDICAL AND DENTAL PLAN FOR SURFACE COMBUSTION INC. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SUPERIOR DENTAL CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96280 )
Policy contract numberD7804
Policy instance 2
Insurance contract or identification numberD7804
Number of Individuals Covered198
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,375
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,375
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP, INC.
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number242230000001
Policy instance 1
Insurance contract or identification number242230000001
Number of Individuals Covered92
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $24,160
Total amount of fees paid to insurance companyUSD $10,081
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,160
Amount paid for insurance broker fees10081
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number00001D030680
Policy instance 3
Insurance contract or identification number00001D030680
Number of Individuals Covered101
Insurance policy start date2015-07-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,016
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,016
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP, INC.
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number242230000001
Policy instance 2
Insurance contract or identification number242230000001
Number of Individuals Covered105
Insurance policy start date2015-07-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $28,233
Total amount of fees paid to insurance companyUSD $10,585
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,233
Amount paid for insurance broker fees10585
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP, INC.
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number2SURF713
Policy instance 1
Insurance contract or identification number2SURF713
Number of Individuals Covered105
Insurance policy start date2015-01-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $3,258
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,583
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,258
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP, INC.
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number242230000001
Policy instance 3
Insurance contract or identification number242230000001
Number of Individuals Covered106
Insurance policy start date2014-07-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $13,477
Total amount of fees paid to insurance companyUSD $13,468
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,477
Amount paid for insurance broker fees13468
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP, INC.
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number2SURF713
Policy instance 2
Insurance contract or identification number2SURF713
Number of Individuals Covered106
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,877
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,877
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP, INC.
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00123848
Policy instance 1
Insurance contract or identification number00123848
Number of Individuals Covered108
Insurance policy start date2014-01-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $20,348
Total amount of fees paid to insurance companyUSD $1,545
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $419,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,744
Insurance broker organization code?3
Amount paid for insurance broker fees1545
Additional information about fees paid to insurance brokerBONUS, OVERRIDE AND NON MONETARY COMPENSATION
Insurance broker nameERC SERVICES INC.
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number2SURF713
Policy instance 3
Insurance contract or identification number2SURF713
Number of Individuals Covered99
Insurance policy start date2013-07-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,584
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,584
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00479330
Policy instance 2
Insurance contract or identification number00479330
Number of Individuals Covered102
Insurance policy start date2013-01-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $3,423
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,423
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP, INC.
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00123848
Policy instance 1
Insurance contract or identification number00123848
Number of Individuals Covered103
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $40,519
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $792,647
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,431
Insurance broker organization code?3
Insurance broker nameERC SERVICES INC.

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