401k Plan data: HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN plan

HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN
Plan identification number	509

HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) 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

HENKELS & MCCOY HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name: HENKELS & MCCOY HOLDINGS, INC.

Employer identification number (EIN): 874043815

NAIC Classification: 237990
NAIC Description: Other Heavy and Civil Engineering Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
509 2022-01-01 DEBRA EMERSON 2023-10-10

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
509	2022-01-01	DEBRA EMERSON	2023-10-10

Plan Statistics for HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,782
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,452
Number of retired or separated participants receiving benefits 2022-01-01 48
Number of other retired or separated participants entitled to future benefits 2022-01-01 30
Total of all active and inactive participants 2022-01-01 1,530
Number of employers contributing to the scheme 2022-01-01 0

Measure	Date	Value
2022: HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,782
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,452
Number of retired or separated participants receiving benefits	2022-01-01	48
Number of other retired or separated participants entitled to future benefits	2022-01-01	30
Total of all active and inactive participants	2022-01-01	1,530
Number of employers contributing to the scheme	2022-01-01	0

Form 5500 Responses for HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN

2022: HENKELS & MCCOY HOLDINGS, INC. EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	First time form 5500 has been submitted	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )

Policy contract number

96733-1-0

Policy instance

Insurance contract or identification number	96733-1-0
Number of Individuals Covered	46
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $313,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )

Policy contract number

21100

Policy instance

Insurance contract or identification number	21100
Number of Individuals Covered	2430
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $92,983
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $929,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $92,983
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

97999821001

Policy instance

Insurance contract or identification number	97999821001
Number of Individuals Covered	2099
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $5,883
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $127,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,883
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

98POINT6 (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

Policy instance

Insurance contract or identification number	34
Number of Individuals Covered	3120
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	TELEHEALTH
Welfare Benefit Premiums Paid to Carrier	USD $33,696
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

681121G

Policy instance

Insurance contract or identification number	681121G
Number of Individuals Covered	1484
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $199,648
Total amount of fees paid to insurance company	USD $17,210
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $1,274,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $199,648
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	BONUS

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Company Name:	HENKELS & MCCOY HOLDINGS, INC.
Employer identification number (EIN):	874043815
NAIC Classification:	237990
NAIC Description:	Other Heavy and Civil Engineering Construction