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WHITE HOUSE CUSTOM COLOUR HEALTH & WELFARE PLAN 401k Plan overview

Plan NameWHITE HOUSE CUSTOM COLOUR HEALTH & WELFARE PLAN
Plan identification number 502

WHITE HOUSE CUSTOM COLOUR HEALTH & WELFARE PLAN Benefits

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

401k Sponsoring company profile

WHITE HOUSE CUSTOM COLOUR, INC. has sponsored the creation of one or more 401k plans.

Company Name:WHITE HOUSE CUSTOM COLOUR, INC.
Employer identification number (EIN):411715624
NAIC Classification:541920

Additional information about WHITE HOUSE CUSTOM COLOUR, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2008-06-27
Company Identification Number: 0800997873
Legal Registered Office Address: 2840 LONE OAK PKWY

EAGAN
United States of America (USA)
55121

More information about WHITE HOUSE CUSTOM COLOUR, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WHITE HOUSE CUSTOM COLOUR HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-07-01

Plan Statistics for WHITE HOUSE CUSTOM COLOUR HEALTH & WELFARE PLAN

401k plan membership statisitcs for WHITE HOUSE CUSTOM COLOUR HEALTH & WELFARE PLAN

Measure Date Value
2022: WHITE HOUSE CUSTOM COLOUR HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01259
Total number of active participants reported on line 7a of the Form 55002022-07-01219
Number of retired or separated participants receiving benefits2022-07-011
Total of all active and inactive participants2022-07-01220
Total participants2022-07-01220

Form 5500 Responses for WHITE HOUSE CUSTOM COLOUR HEALTH & WELFARE PLAN

2022: WHITE HOUSE CUSTOM COLOUR HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01First time form 5500 has been submittedYes
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 )
Policy contract numberPCH10633
Policy instance 1
Insurance contract or identification numberPCH10633
Number of Individuals Covered128
Total amount of commissions paid to insurance brokerUSD $36,542
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $798,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,542
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number098033
Policy instance 2
Insurance contract or identification number098033
Number of Individuals Covered219
Total amount of commissions paid to insurance brokerUSD $9,269
Total amount of fees paid to insurance companyUSD $1,081
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $61,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,269
Amount paid for insurance broker fees1081
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30056049
Policy instance 3
Insurance contract or identification number30056049
Number of Individuals Covered83
Total amount of commissions paid to insurance brokerUSD $1,132
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,132
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3924685
Policy instance 4
Insurance contract or identification numberE3924685
Number of Individuals Covered4
Total amount of commissions paid to insurance brokerUSD $704
Total amount of fees paid to insurance companyUSD $81
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedMEDICAL BRIDGE
Welfare Benefit Premiums Paid to CarrierUSD $3,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $175
Amount paid for insurance broker fees32
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number419017
Policy instance 5
Insurance contract or identification number419017
Number of Individuals Covered18
Total amount of commissions paid to insurance brokerUSD $872
Total amount of fees paid to insurance companyUSD $102
Life Insurance Welfare BenefitYes
Other welfare benefits providedLIFESTYLE ADD
Welfare Benefit Premiums Paid to CarrierUSD $5,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $872
Amount paid for insurance broker fees102
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3

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