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GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC. 401k Plan overview

Plan NameGROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC.
Plan identification number 501

GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

NOBILITY HOMES, INC. has sponsored the creation of one or more 401k plans.

Company Name:NOBILITY HOMES, INC.
Employer identification number (EIN):591166102
NAIC Classification:321900

Additional information about NOBILITY HOMES, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1997-11-06
Company Identification Number: 19971178057
Legal Registered Office Address: 234 Columbine Street
Suite 320
Denver
United States of America (USA)
80209

More information about NOBILITY HOMES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01MARIA FROBISH2024-09-17
5012023-01-01MARIA FROBISH2024-06-26
5012022-01-01MARIA FROBISH2023-05-08
5012022-01-01MARIA FROBISH2024-05-07
5012021-01-01MARIA FROBISH2022-08-04
5012021-01-01MARIA FROBISH2024-05-07
5012020-01-01MARIA FROBISH2021-10-07
5012020-01-01MARIA FROBISH2022-01-27
5012020-01-01MARIA FROBISH2024-05-07
5012019-01-01
5012018-01-01

Form 5500 Responses for GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC.

2024: GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC. 2024 form 5500 responses
2024-01-01Type of plan entitySingle employer plan
2024-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2024-01-01Plan funding arrangement – InsuranceYes
2024-01-01Plan funding arrangement – General assets of the sponsorYes
2024-01-01Plan benefit arrangement – InsuranceYes
2024-01-01Plan benefit arrangement – General assets of the sponsorYes
2023: GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC. 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: GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC. 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC. 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC. 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC. 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GROUP WELFARE AND ANCILLARY FOR NOBILITY HOMES, INC. 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number171103
Policy instance 2
Insurance contract or identification number171103
Number of Individuals Covered130
Insurance policy start date2024-01-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $2,788
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL,ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $5,169
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHIEST YOU (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHY6635
Policy instance 1
Insurance contract or identification numberHY6635
Number of Individuals Covered16
Insurance policy start date2024-01-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $105
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTELEHEALTH
Welfare Benefit Premiums Paid to CarrierUSD $702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number171103
Policy instance 2
Insurance contract or identification number171103
Number of Individuals Covered133
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $19,584
Total amount of fees paid to insurance companyUSD $2,002
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL,ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $19,494
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHIEST YOU (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHY6635
Policy instance 1
Insurance contract or identification numberHY6635
Number of Individuals Covered16
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $421
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTELEHEALTH
Welfare Benefit Premiums Paid to CarrierUSD $2,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number16168
Policy instance 1
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number534819
Policy instance 2
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number16168
Policy instance 3
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number16168
Policy instance 4
HEALTHIEST YOU (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHY6635
Policy instance 4
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number16168
Policy instance 5
HEALTHIEST YOU (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHY6635
Policy instance 4
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number16168
Policy instance 5
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number16168
Policy instance 4
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number16168
Policy instance 3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number534819
Policy instance 2
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number16168
Policy instance 1
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number16168
Policy instance 4
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number16168
Policy instance 3
Insurance contract or identification number16168
Number of Individuals Covered30
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,285
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number534819
Policy instance 2
Insurance contract or identification number534819
Number of Individuals Covered66
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $557
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number16168
Policy instance 1
Insurance contract or identification number16168
Number of Individuals Covered31
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $13,730
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHIEST YOU (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHY6635
Policy instance 4
Insurance contract or identification numberHY6635
Number of Individuals Covered20
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $450
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTELEHEALTH
Welfare Benefit Premiums Paid to CarrierUSD $2,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number16168
Policy instance 5
Insurance contract or identification number16168
Number of Individuals Covered111
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,637
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $46,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number16168
Policy instance 1
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number16168
Policy instance 2
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract numberE0559 - 179L71
Policy instance 3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number534819
Policy instance 4
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number534819
Policy instance 5
FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 )
Policy contract number16168
Policy instance 4
FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 )
Policy contract numberE0559 - 179L71
Policy instance 3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number16168
Policy instance 2
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number16168
Policy instance 1

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