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| Plan Name | PREMIER PRECISION MACHINING EMPLOYEE BENEFITS PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PREMIER PRECISION MACHINING LLC |
| Employer identification number (EIN): | 822520591 |
| NAIC Classification: | 332700 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2022-10-01 | ANDY MATTISON | 2024-02-26 | ||
| 502 | 2021-10-01 | ANDY MATTISON | 2023-01-25 |
| Measure | Date | Value |
|---|---|---|
| 2022: PREMIER PRECISION MACHINING EMPLOYEE BENEFITS PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-10-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-01 | 113 |
| Number of retired or separated participants receiving benefits | 2022-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-10-01 | 0 |
| Total of all active and inactive participants | 2022-10-01 | 113 |
| Number of employers contributing to the scheme | 2022-10-01 | 0 |
| 2021: PREMIER PRECISION MACHINING EMPLOYEE BENEFITS PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-10-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 129 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 129 |
| Number of employers contributing to the scheme | 2021-10-01 | 0 |
| 2022: PREMIER PRECISION MACHINING EMPLOYEE BENEFITS PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: PREMIER PRECISION MACHINING EMPLOYEE BENEFITS PLAN 2021 form 5500 responses | ||
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | First time form 5500 has been submitted | Yes |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: 55204 ) | |
| Policy contract number | 11443733 |
| Policy instance | 1 |
| PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68209 ) | |
| Policy contract number | 477408 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) | |
| Policy contract number | 40150401 |
| Policy instance | 3 |
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |
| Policy contract number | 879863 |
| Policy instance | 4 |
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: 55204 ) | |
| Policy contract number | 11443733 |
| Policy instance | 1 |
| PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68209 ) | |
| Policy contract number | 477408 |
| Policy instance | 2 |
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |
| Policy contract number | 879863 |
| Policy instance | 3 |
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