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EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan NameEMPLOYEE BENEFITS PLAN
Plan identification number 501

EMPLOYEE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

ADS SERVICES LLC has sponsored the creation of one or more 401k plans.

Company Name:ADS SERVICES LLC
Employer identification number (EIN):821090422
NAIC Classification:532400
NAIC Description: Commercial and Industrial Machinery and Equipment Rental and Leasing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-10-01BARBARA SOUSLIN2024-12-18

Plan Statistics for EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for EMPLOYEE BENEFITS PLAN

Measure Date Value
2023: EMPLOYEE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year2023-10-01100
Total number of active participants reported on line 7a of the Form 55002023-10-0191
Number of retired or separated participants receiving benefits2023-10-010
Number of other retired or separated participants entitled to future benefits2023-10-010
Total of all active and inactive participants2023-10-0191
Number of employers contributing to the scheme2023-10-010

Form 5500 Responses for EMPLOYEE BENEFITS PLAN

2023: EMPLOYEE BENEFITS PLAN 2023 form 5500 responses
2023-10-01Type of plan entitySingle employer plan
2023-10-01First time form 5500 has been submittedYes
2023-10-01Plan funding arrangement – InsuranceYes
2023-10-01Plan funding arrangement – General assets of the sponsorYes
2023-10-01Plan benefit arrangement – InsuranceYes
2023-10-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number276914
Policy instance 1
Insurance contract or identification number276914
Number of Individuals Covered173
Insurance policy start date2023-10-01
Insurance policy end date2024-09-30
Total amount of commissions paid to insurance brokerUSD $57,851
Total amount of fees paid to insurance companyUSD $711
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,283,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1145906
Policy instance 2
Insurance contract or identification number1145906
Number of Individuals Covered184
Insurance policy start date2023-10-01
Insurance policy end date2024-09-30
Total amount of commissions paid to insurance brokerUSD $13,769
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $98,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

Potentially related plans

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