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EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameEMPLOYEE BENEFIT PLAN
Plan identification number 501

EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Vision
  • 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

M.R. TANNER DEVELOPMENT & CONSTRUCTION, LLC DBA M.R. TANNER CONSTRUCTI has sponsored the creation of one or more 401k plans.

Company Name:M.R. TANNER DEVELOPMENT & CONSTRUCTION, LLC DBA M.R. TANNER CONSTRUCTI
Employer identification number (EIN):860821266
NAIC Classification:237210
NAIC Description:Land Subdivision

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012009-02-01GREGORY J MARSH MAURICE TANNER2010-10-06
5012009-02-01ROXANNE BAKER2021-06-10

Plan Statistics for EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN

Measure Date Value
2009: EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-02-0131
Total number of active participants reported on line 7a of the Form 55002009-02-0121
Total of all active and inactive participants2009-02-0121
Total participants2009-02-0121
Number of retired or separated participants receiving benefits2009-02-010
Number of other retired or separated participants entitled to future benefits2009-02-010
Number of employers contributing to the scheme2009-02-010

Form 5500 Responses for EMPLOYEE BENEFIT PLAN

2009: EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-02-01Type of plan entityMulitple employer plan
2009-02-01Submission has been amendedYes
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract numberS5011B1
Policy instance 1
Insurance contract or identification numberS5011B1
Number of Individuals Covered21
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract numberS5011B1
Policy instance 2
Insurance contract or identification numberS5011B1
Number of Individuals Covered21
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $8,683
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees8683
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?5
MEDCOM CARE MANAGEMENT, INC. (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberS5011B1
Policy instance 3
Insurance contract or identification numberS5011B1
Number of Individuals Covered21
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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