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CENTRO DE LA FAMILIA DE UTAH HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameCENTRO DE LA FAMILIA DE UTAH HEALTH AND WELFARE PLAN
Plan identification number 501

CENTRO DE LA FAMILIA DE UTAH HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

CENTRO DE LA FAMILA DE UTAH has sponsored the creation of one or more 401k plans.

Company Name:CENTRO DE LA FAMILA DE UTAH
Employer identification number (EIN):870310109
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CENTRO DE LA FAMILIA DE UTAH HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-05-01DAVID STUMP2024-09-25

Plan Statistics for CENTRO DE LA FAMILIA DE UTAH HEALTH AND WELFARE PLAN

401k plan membership statisitcs for CENTRO DE LA FAMILIA DE UTAH HEALTH AND WELFARE PLAN

Measure Date Value
2023: CENTRO DE LA FAMILIA DE UTAH HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-05-01100
Total number of active participants reported on line 7a of the Form 55002023-05-01481
Number of retired or separated participants receiving benefits2023-05-010
Number of other retired or separated participants entitled to future benefits2023-05-010
Total of all active and inactive participants2023-05-01481
Number of employers contributing to the scheme2023-05-010

Form 5500 Responses for CENTRO DE LA FAMILIA DE UTAH HEALTH AND WELFARE PLAN

2023: CENTRO DE LA FAMILIA DE UTAH HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-05-01Type of plan entitySingle employer plan
2023-05-01First time form 5500 has been submittedYes
2023-05-01Plan funding arrangement – InsuranceYes
2023-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number9586
Policy instance 1
Insurance contract or identification number9586
Number of Individuals Covered375
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $6,826
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $50,088
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF UTAH (National Association of Insurance Commissioners NAIC id number: 54550 )
Policy contract number10049808
Policy instance 2
Insurance contract or identification number10049808
Number of Individuals Covered290
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $52,766
Total amount of fees paid to insurance companyUSD $8,520
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,756,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 )
Policy contract number2290
Policy instance 3
Insurance contract or identification number2290
Number of Individuals Covered384
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $7,608
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $126,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLOMQUIST HALE CONSULTING INC (National Association of Insurance Commissioners NAIC id number: 10310 )
Policy contract numberEAP
Policy instance 4
Insurance contract or identification numberEAP
Number of Individuals Covered481
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $20,965
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number31571
Policy instance 5
Insurance contract or identification number31571
Number of Individuals Covered69
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $4,830
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $24,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number2290
Policy instance 6
Insurance contract or identification number2290
Number of Individuals Covered299
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $2,196
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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