OPTA (USA) INC. has sponsored the creation of one or more 401k plans.
Additional information about OPTA (USA) INC.
Submission information for form 5500 for 401k plan ESM GROUP INC. SELF FUNDED MEDICAL PLAN
401k plan membership statisitcs for ESM GROUP INC. SELF FUNDED MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2021: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-09-01 | 208 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 222 |
| Number of retired or separated participants receiving benefits | 2021-09-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2021-09-01 | 3 |
| Total of all active and inactive participants | 2021-09-01 | 228 |
| 2019: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 166 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 7 |
| Total of all active and inactive participants | 2019-01-01 | 173 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0149899 |
| Policy instance | 1 |
| Insurance contract or identification number | 0149899 | | Number of Individuals Covered | 438 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $83,131 | | Total amount of fees paid to insurance company | USD $3,775 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,629,457 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $83,131 | | Amount paid for insurance broker fees | 3775 | | Additional information about fees paid to insurance broker | KEY PRODUCER OVERRIDE 2% | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00576886 |
| Policy instance | 2 |
| Insurance contract or identification number | 00576886 | | Number of Individuals Covered | 222 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $28,081 | | Total amount of fees paid to insurance company | USD $14,753 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D AND CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $399,742 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,081 | | Amount paid for insurance broker fees | 14753 | | Insurance broker organization code? | 3 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00093962 |
| Policy instance | 1 |
| Insurance contract or identification number | 00093962 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $10,279 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $226,750 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,279 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00413285 |
| Policy instance | 2 |
| Insurance contract or identification number | 00413285 | | Number of Individuals Covered | 161 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $34,320 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,320 | | Insurance broker organization code? | 3 |
|
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