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HEALTH INSURANCE PLAN FOR THE EMPLOYEES OF SHOTTENKIRK HUNTSVILLE HH 401k Plan overview

Plan NameHEALTH INSURANCE PLAN FOR THE EMPLOYEES OF SHOTTENKIRK HUNTSVILLE HH
Plan identification number 501

HEALTH INSURANCE PLAN FOR THE EMPLOYEES OF SHOTTENKIRK HUNTSVILLE HH 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
  • Other welfare benefit cover

401k Sponsoring company profile

SHOTTENKIRK HUNTSVILLE SHH has sponsored the creation of one or more 401k plans.

Company Name:SHOTTENKIRK HUNTSVILLE SHH
Employer identification number (EIN):872942453
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH INSURANCE PLAN FOR THE EMPLOYEES OF SHOTTENKIRK HUNTSVILLE HH

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-05-01KATHY FLOYD2023-02-13

Plan Statistics for HEALTH INSURANCE PLAN FOR THE EMPLOYEES OF SHOTTENKIRK HUNTSVILLE HH

401k plan membership statisitcs for HEALTH INSURANCE PLAN FOR THE EMPLOYEES OF SHOTTENKIRK HUNTSVILLE HH

Measure Date Value
2021: HEALTH INSURANCE PLAN FOR THE EMPLOYEES OF SHOTTENKIRK HUNTSVILLE HH 2021 401k membership
Total participants, beginning-of-year2021-05-01184
Total number of active participants reported on line 7a of the Form 55002021-05-01210
Total of all active and inactive participants2021-05-01210

Form 5500 Responses for HEALTH INSURANCE PLAN FOR THE EMPLOYEES OF SHOTTENKIRK HUNTSVILLE HH

2021: HEALTH INSURANCE PLAN FOR THE EMPLOYEES OF SHOTTENKIRK HUNTSVILLE HH 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number15774
Policy instance 1
Insurance contract or identification number15774
Number of Individuals Covered162
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LLOYD'S OF LONDON (National Association of Insurance Commissioners NAIC id number: AA-11 )
Policy contract numberJDAM000119
Policy instance 2
Insurance contract or identification numberJDAM000119
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number888232G
Policy instance 3
Insurance contract or identification number888232G
Number of Individuals Covered210
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $27,610
Total amount of fees paid to insurance companyUSD $16,582
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D-VOLUNTARY CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $59,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,932
Amount paid for insurance broker fees16582
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number90183
Policy instance 4
Insurance contract or identification number90183
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberSDPSCHAJ
Policy instance 5
Insurance contract or identification numberSDPSCHAJ
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, CRITICAL ILLNESS
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Insurance broker organization code?3

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