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THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 401k Plan overview

Plan NameTHE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN
Plan identification number 501

THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN Benefits

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

401k Sponsoring company profile

CHANTILLY CRUSHED STONE INC has sponsored the creation of one or more 401k plans.

Company Name:CHANTILLY CRUSHED STONE INC
Employer identification number (EIN):541299398
NAIC Classification:484200
NAIC Description: Specialized Freight Trucking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-09-01
5012019-09-01
5012018-09-01
5012017-09-01DEBBIE CARROLL DEBBIE CARROLL2019-02-15
5012016-09-01DEBBIE CARROLL DEBBIE CARROLL2018-06-12
5012015-09-01DEBBIE CARROLL DEBBIE CARROLL2016-11-30
5012014-09-01DEBBIE CARROLL DEBBIE CARROLL2016-04-01
5012013-09-01DEBBIE CARROLL DEBBIE CARROLL2016-04-15
5012012-09-01DEBBIE CARROLL DEBBIE CARROLL2014-06-05
5012011-09-01DEBBIE CARROLL DEBBIE CARROLL2013-04-24
5012010-09-01LYNETTE BAKER
5012010-09-01LYNETTE BAKER
5012009-09-01LYNETTE BAKER

Plan Statistics for THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN

401k plan membership statisitcs for THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN

Measure Date Value
2020: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01118
Total number of active participants reported on line 7a of the Form 55002020-09-01116
Total of all active and inactive participants2020-09-01116
Total participants2020-09-01116
2019: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01127
Total number of active participants reported on line 7a of the Form 55002019-09-01116
Total of all active and inactive participants2019-09-01116
Total participants2019-09-01116
2018: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01128
Total number of active participants reported on line 7a of the Form 55002018-09-01124
Total of all active and inactive participants2018-09-01124
Total participants2018-09-01124
2017: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01126
Total number of active participants reported on line 7a of the Form 55002017-09-01125
Total of all active and inactive participants2017-09-01125
Total participants2017-09-01125
2016: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01125
Total number of active participants reported on line 7a of the Form 55002016-09-01122
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01122
Total participants2016-09-01122
2015: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01128
Total number of active participants reported on line 7a of the Form 55002015-09-01123
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-01123
Total participants2015-09-01123
2014: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01126
Total number of active participants reported on line 7a of the Form 55002014-09-01126
Number of retired or separated participants receiving benefits2014-09-010
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-01126
Total participants2014-09-01126
2013: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01119
Total number of active participants reported on line 7a of the Form 55002013-09-01117
Total of all active and inactive participants2013-09-01117
Total participants2013-09-01117
2012: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01133
Total number of active participants reported on line 7a of the Form 55002012-09-01122
Number of retired or separated participants receiving benefits2012-09-010
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-01122
Total participants2012-09-01122
2011: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01138
Total number of active participants reported on line 7a of the Form 55002011-09-01132
Number of retired or separated participants receiving benefits2011-09-010
Number of other retired or separated participants entitled to future benefits2011-09-010
Total of all active and inactive participants2011-09-01132
Total participants2011-09-01132
2010: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-09-01136
Total number of active participants reported on line 7a of the Form 55002010-09-01132
Number of retired or separated participants receiving benefits2010-09-010
Number of other retired or separated participants entitled to future benefits2010-09-010
Total of all active and inactive participants2010-09-01132
2009: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-01136
Total number of active participants reported on line 7a of the Form 55002009-09-01132
Number of retired or separated participants receiving benefits2009-09-010
Number of other retired or separated participants entitled to future benefits2009-09-010
Total of all active and inactive participants2009-09-01132

Form 5500 Responses for THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN

2020: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)No
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)No
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – General assets of the sponsorYes
2012-09-01Plan benefit arrangement – General assets of the sponsorYes
2011: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – General assets of the sponsorYes
2011-09-01Plan benefit arrangement – General assets of the sponsorYes
2010: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2010 form 5500 responses
2010-09-01Type of plan entitySingle employer plan
2010-09-01Submission has been amendedNo
2010-09-01This submission is the final filingNo
2010-09-01This return/report is a short plan year return/report (less than 12 months)No
2010-09-01Plan is a collectively bargained planNo
2010-09-01Plan funding arrangement – General assets of the sponsorYes
2010-09-01Plan benefit arrangement – General assets of the sponsorYes
2009: THE CHANTILLY CRUSHED STONE INC EMPLOYEE MEDICAL PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – General assets of the sponsorYes
2009-09-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-202205
Policy instance 1
Insurance contract or identification numberUNI-202205
Number of Individuals Covered116
Insurance policy start date2019-09-01
Insurance policy end date2020-08-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2594
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?3
Welfare Benefit Premiums Paid to CarrierUSD $439,101
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-202205
Policy instance 1
Insurance contract or identification numberUNI-202205
Number of Individuals Covered124
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $506,045
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees409969
Additional information about fees paid to insurance brokerSTOP/LOSS
Insurance broker organization code?3
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-202205
Policy instance 1
Insurance contract or identification numberUNI-202205
Number of Individuals Covered125
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $460,198
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
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 number00193341
Policy instance 1
Insurance contract or identification number00193341
Number of Individuals Covered123
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of fees paid to insurance companyUSD $422,089
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees109
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
Insurance broker nameOPTUM HEALTH/UNIMERICA GROSS PREMIU
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00193341
Policy instance 1
Insurance contract or identification number00193341
Number of Individuals Covered126
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of fees paid to insurance companyUSD $413,878
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees327467
Additional information about fees paid to insurance brokerSTOP/LOSS
Insurance broker organization code?3
Insurance broker nameTC3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00193341
Policy instance 1
Insurance contract or identification number00193341
Number of Individuals Covered117
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of fees paid to insurance companyUSD $388,944
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Amount paid for insurance broker fees1595
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameSYMETRA GROSS PREMIUM

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