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LIFE AND AD&D 401k Plan overview

Plan NameLIFE AND AD&D
Plan identification number 501

LIFE AND AD&D Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

MICHAEL B. BAYLESS & ASSOCIATES, LLC. has sponsored the creation of one or more 401k plans.

Company Name:MICHAEL B. BAYLESS & ASSOCIATES, LLC.
Employer identification number (EIN):860485904
NAIC Classification:621112
NAIC Description:Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE AND AD&D

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-10-01GRAHAM JOHNSON2021-04-27
5012018-10-01JUSTIN BAYLESS2020-02-05
5012017-10-01LISA ELOWSON2019-05-23

Plan Statistics for LIFE AND AD&D

401k plan membership statisitcs for LIFE AND AD&D

Measure Date Value
2019: LIFE AND AD&D 2019 401k membership
Total participants, beginning-of-year2019-10-01165
Total number of active participants reported on line 7a of the Form 55002019-10-010
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-010
Number of employers contributing to the scheme2019-10-010
2018: LIFE AND AD&D 2018 401k membership
Total participants, beginning-of-year2018-10-01132
Total number of active participants reported on line 7a of the Form 55002018-10-01161
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01161
Number of employers contributing to the scheme2018-10-010
2017: LIFE AND AD&D 2017 401k membership
Total participants, beginning-of-year2017-10-01105
Total number of active participants reported on line 7a of the Form 55002017-10-01132
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01132
Number of employers contributing to the scheme2017-10-010

Form 5500 Responses for LIFE AND AD&D

2019: LIFE AND AD&D 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01This submission is the final filingYes
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: LIFE AND AD&D 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: LIFE AND AD&D 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01First time form 5500 has been submittedYes
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1035423
Policy instance 1
Insurance contract or identification number1035423
Number of Individuals Covered307
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $9,936
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 $141,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,330
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1035423
Policy instance 1
Insurance contract or identification number1035423
Number of Individuals Covered219
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $8,265
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 $113,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,238
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number7X2511
Policy instance 1
Insurance contract or identification number7X2511
Number of Individuals Covered195
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $23,458
Total amount of fees paid to insurance companyUSD $814
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $403,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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