401k Plan data: UPPER CUMBERLAND ELECTRIC MEMBERSHIP CORPORATION EMPLOYEE BENEFIT PLAN plan

UPPER CUMBERLAND ELECTRIC MEMBERSHIP CORPORATION EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	UPPER CUMBERLAND ELECTRIC MEMBERSHIP CORPORATION EMPLOYEE BENEFIT PLAN
Plan identification number	501

UPPER CUMBERLAND ELECTRIC MEMBERSHIP CORPORATION EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	SELECT distinct(Description) AS Description FROM 401k_benefit_codes LEFT JOIN 401k_benefit_code_description ON BenefitCode=Code COLLATE utf8_unicode_ci WHERE EIN='620393118' AND PlanID='501'

401k Sponsoring company profile

UPPER CUMBERLAND ELECTRIC MEMBERSHI has sponsored the creation of one or more 401k plans.

Company Name: UPPER CUMBERLAND ELECTRIC MEMBERSHI

Employer identification number (EIN): 620393118

NAIC Classification: 221100

Additional information about UPPER CUMBERLAND ELECTRIC MEMBERSHI

Jurisdiction of Incorporation: Tennessee Secretary of State Division of Business Services

Incorporation Date:

Company Identification Number: 000086545

More information about UPPER CUMBERLAND ELECTRIC MEMBERSHI

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UPPER CUMBERLAND ELECTRIC MEMBERSHIP CORPORATION EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-07-01 JENNIFER BROGDON 2025-01-09 JENNIFER BROGDON 2025-01-09
501 2022-07-01 JENNIFER BROGDON 2024-02-09
501 2021-07-01 JENNIFER BROGDON 2023-01-03
501 2020-07-01 JENNIFER BROGDON 2022-01-24
501 2019-07-01 JENNIFER BROGDON 2021-02-16
501 2018-07-01 JIMMY GREGORY 2020-10-28
501 2017-07-01
501 2017-07-01 JIMMY GREGORY 2020-10-28
501 2016-07-01 JERRY HARPER JERRY HARPER 2018-06-21
501 2016-07-01 JIMMY GREGORY 2020-10-29

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-07-01	JENNIFER BROGDON	2025-01-09	JENNIFER BROGDON	2025-01-09
501	2022-07-01	JENNIFER BROGDON	2024-02-09
501	2021-07-01	JENNIFER BROGDON	2023-01-03
501	2020-07-01	JENNIFER BROGDON	2022-01-24
501	2019-07-01	JENNIFER BROGDON	2021-02-16
501	2018-07-01	JIMMY GREGORY	2020-10-28
501	2017-07-01
501	2017-07-01	JIMMY GREGORY	2020-10-28
501	2016-07-01	JERRY HARPER		JERRY HARPER	2018-06-21
501	2016-07-01	JIMMY GREGORY	2020-10-29

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

00000918745

Policy instance

Insurance contract or identification number	00000918745
Number of Individuals Covered	125
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $3,005
Total amount of fees paid to insurance company	USD $1,638
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $42,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )

Policy contract number

141732

Policy instance

Insurance contract or identification number	141732
Number of Individuals Covered	233
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $19,647
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $1,050,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )

Policy contract number

141732

Policy instance

BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )

Policy contract number

141732

Policy instance

BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )

Policy contract number

141732

Policy instance

BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )

Policy contract number

141732

Policy instance

BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )

Policy contract number

141732

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30068120

Policy instance

GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )

Policy contract number

GER-P16-906R

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30068120

Policy instance

GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )

Policy contract number

GER-P16-906R

Policy instance

GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )

Policy contract number

NOT PROVIDED

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30068120

Policy instance

GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )

Policy contract number

NOT PROVIDED

Policy instance

Potentially related plans

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Company Name:	UPPER CUMBERLAND ELECTRIC MEMBERSHI
Employer identification number (EIN):	620393118
NAIC Classification:	221100

Jurisdiction of Incorporation:	Tennessee Secretary of State Division of Business Services
Incorporation Date:
Company Identification Number:	000086545