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GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 401k Plan overview

Plan NameGROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S.
Plan identification number 501

GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 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
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

CLARK NUBER, P.S. has sponsored the creation of one or more 401k plans.

Company Name:CLARK NUBER, P.S.
Employer identification number (EIN):911194016
NAIC Classification:541211
NAIC Description:Offices of Certified Public Accountants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01SARAH PETRONE2024-07-11
5012022-12-01THOMAS J. SULEWSKI2023-06-30
5012021-12-01THOMAS J. SULEWSKI2023-06-30
5012020-12-01ROB WHEELER2022-06-21
5012019-12-01ROBERT WHEELER2021-09-08
5012016-12-01
5012015-12-01ROBERT A WHEELER
5012014-12-01ROBERT A WHEELER
5012013-12-01ROBERT A WHEELER
5012012-12-01DAVID KATRI
5012011-12-01DAVE KATRI
5012010-12-01DAVE KATRI
5012009-12-01 DAVID E KATRI2011-05-16
5012009-12-01DAVE KATRI
5012009-12-01 DAVID KATRI2011-05-16
5012008-12-01

Plan Statistics for GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S.

401k plan membership statisitcs for GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S.

Measure Date Value
2023: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2023 401k membership
Total participants, beginning-of-year2023-01-01270
Total number of active participants reported on line 7a of the Form 55002023-01-01284
Number of retired or separated participants receiving benefits2023-01-013
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01287
Number of employers contributing to the scheme2023-01-010
2022: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2022 401k membership
Total participants, beginning-of-year2022-12-01261
Total number of active participants reported on line 7a of the Form 55002022-12-01268
Number of retired or separated participants receiving benefits2022-12-012
Number of other retired or separated participants entitled to future benefits2022-12-010
Total of all active and inactive participants2022-12-01270
Number of employers contributing to the scheme2022-12-010
2021: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2021 401k membership
Total participants, beginning-of-year2021-12-01226
Total number of active participants reported on line 7a of the Form 55002021-12-01260
Number of retired or separated participants receiving benefits2021-12-011
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-01261
Number of employers contributing to the scheme2021-12-010
2020: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2020 401k membership
Total participants, beginning-of-year2020-12-01226
Total number of active participants reported on line 7a of the Form 55002020-12-01225
Number of retired or separated participants receiving benefits2020-12-011
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-01226
Number of employers contributing to the scheme2020-12-010
2019: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2019 401k membership
Total participants, beginning-of-year2019-12-01205
Total number of active participants reported on line 7a of the Form 55002019-12-01226
Number of retired or separated participants receiving benefits2019-12-012
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01228
Number of employers contributing to the scheme2019-12-010
2016: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2016 401k membership
Total participants, beginning-of-year2016-12-01185
Total number of active participants reported on line 7a of the Form 55002016-12-01199
Number of retired or separated participants receiving benefits2016-12-010
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-01199
2015: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2015 401k membership
Total participants, beginning-of-year2015-12-01183
Total number of active participants reported on line 7a of the Form 55002015-12-01185
Number of retired or separated participants receiving benefits2015-12-010
Number of other retired or separated participants entitled to future benefits2015-12-010
Total of all active and inactive participants2015-12-01185
2014: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2014 401k membership
Total participants, beginning-of-year2014-12-01180
Total number of active participants reported on line 7a of the Form 55002014-12-01183
Number of retired or separated participants receiving benefits2014-12-010
Number of other retired or separated participants entitled to future benefits2014-12-010
Total of all active and inactive participants2014-12-01183
2013: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2013 401k membership
Total participants, beginning-of-year2013-12-01173
Total number of active participants reported on line 7a of the Form 55002013-12-01180
Number of retired or separated participants receiving benefits2013-12-010
Number of other retired or separated participants entitled to future benefits2013-12-010
Total of all active and inactive participants2013-12-01180
2012: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2012 401k membership
Total participants, beginning-of-year2012-12-01157
Total number of active participants reported on line 7a of the Form 55002012-12-01173
Number of retired or separated participants receiving benefits2012-12-010
Number of other retired or separated participants entitled to future benefits2012-12-010
Total of all active and inactive participants2012-12-01173
2011: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2011 401k membership
Total participants, beginning-of-year2011-12-01151
Total number of active participants reported on line 7a of the Form 55002011-12-01157
Number of retired or separated participants receiving benefits2011-12-010
Number of other retired or separated participants entitled to future benefits2011-12-010
Total of all active and inactive participants2011-12-01157
2010: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2010 401k membership
Total participants, beginning-of-year2010-12-01153
Total number of active participants reported on line 7a of the Form 55002010-12-01151
Number of retired or separated participants receiving benefits2010-12-010
Number of other retired or separated participants entitled to future benefits2010-12-010
Total of all active and inactive participants2010-12-01151
2009: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2009 401k membership
Total participants, beginning-of-year2009-12-01156
Total number of active participants reported on line 7a of the Form 55002009-12-01153
Number of retired or separated participants receiving benefits2009-12-010
Number of other retired or separated participants entitled to future benefits2009-12-010
Total of all active and inactive participants2009-12-01153

Form 5500 Responses for GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S.

2023: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2022 form 5500 responses
2022-12-01Type of plan entitySingle employer plan
2022-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-12-01Plan funding arrangement – InsuranceYes
2022-12-01Plan funding arrangement – General assets of the sponsorYes
2022-12-01Plan benefit arrangement – InsuranceYes
2022-12-01Plan benefit arrangement – General assets of the sponsorYes
2021: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – General assets of the sponsorYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – General assets of the sponsorYes
2020: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan funding arrangement – General assets of the sponsorYes
2020-12-01Plan benefit arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – General assets of the sponsorYes
2019: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan funding arrangement – General assets of the sponsorYes
2019-12-01Plan benefit arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – General assets of the sponsorYes
2016: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan funding arrangement – General assets of the sponsorYes
2016-12-01Plan benefit arrangement – InsuranceYes
2016-12-01Plan benefit arrangement – General assets of the sponsorYes
2015: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Submission has been amendedNo
2015-12-01This submission is the final filingNo
2015-12-01This return/report is a short plan year return/report (less than 12 months)No
2015-12-01Plan is a collectively bargained planNo
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan funding arrangement – General assets of the sponsorYes
2015-12-01Plan benefit arrangement – InsuranceYes
2015-12-01Plan benefit arrangement – General assets of the sponsorYes
2014: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01Submission has been amendedNo
2014-12-01This submission is the final filingNo
2014-12-01This return/report is a short plan year return/report (less than 12 months)No
2014-12-01Plan is a collectively bargained planNo
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan funding arrangement – General assets of the sponsorYes
2014-12-01Plan benefit arrangement – InsuranceYes
2014-12-01Plan benefit arrangement – General assets of the sponsorYes
2013: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2013 form 5500 responses
2013-12-01Type of plan entitySingle employer plan
2013-12-01Submission has been amendedNo
2013-12-01This submission is the final filingNo
2013-12-01This return/report is a short plan year return/report (less than 12 months)No
2013-12-01Plan is a collectively bargained planNo
2013-12-01Plan funding arrangement – InsuranceYes
2013-12-01Plan funding arrangement – General assets of the sponsorYes
2013-12-01Plan benefit arrangement – InsuranceYes
2013-12-01Plan benefit arrangement – General assets of the sponsorYes
2012: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2012 form 5500 responses
2012-12-01Type of plan entitySingle employer plan
2012-12-01Submission has been amendedNo
2012-12-01This submission is the final filingNo
2012-12-01This return/report is a short plan year return/report (less than 12 months)No
2012-12-01Plan is a collectively bargained planNo
2012-12-01Plan funding arrangement – InsuranceYes
2012-12-01Plan funding arrangement – General assets of the sponsorYes
2012-12-01Plan benefit arrangement – InsuranceYes
2012-12-01Plan benefit arrangement – General assets of the sponsorYes
2011: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2011 form 5500 responses
2011-12-01Type of plan entitySingle employer plan
2011-12-01Submission has been amendedNo
2011-12-01This submission is the final filingNo
2011-12-01This return/report is a short plan year return/report (less than 12 months)No
2011-12-01Plan is a collectively bargained planNo
2011-12-01Plan funding arrangement – InsuranceYes
2011-12-01Plan funding arrangement – General assets of the sponsorYes
2011-12-01Plan benefit arrangement – InsuranceYes
2011-12-01Plan benefit arrangement – General assets of the sponsorYes
2010: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2010 form 5500 responses
2010-12-01Type of plan entitySingle employer plan
2010-12-01Submission has been amendedNo
2010-12-01This submission is the final filingNo
2010-12-01This return/report is a short plan year return/report (less than 12 months)No
2010-12-01Plan is a collectively bargained planNo
2010-12-01Plan funding arrangement – InsuranceYes
2010-12-01Plan funding arrangement – General assets of the sponsorYes
2010-12-01Plan benefit arrangement – InsuranceYes
2010-12-01Plan benefit arrangement – General assets of the sponsorYes
2009: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2009 form 5500 responses
2009-12-01Type of plan entitySingle employer plan
2009-12-01Submission has been amendedNo
2009-12-01This submission is the final filingNo
2009-12-01This return/report is a short plan year return/report (less than 12 months)No
2009-12-01Plan is a collectively bargained planNo
2009-12-01Plan funding arrangement – InsuranceYes
2009-12-01Plan funding arrangement – General assets of the sponsorYes
2009-12-01Plan benefit arrangement – InsuranceYes
2009-12-01Plan benefit arrangement – General assets of the sponsorYes
2008: GROUP HEALTH & WELFARE PLAN FOR EMPLOYEES OF CLARK NUBER P.S. 2008 form 5500 responses
2008-12-01Type of plan entitySingle employer plan
2008-12-01Submission has been amendedNo
2008-12-01This submission is the final filingNo
2008-12-01This return/report is a short plan year return/report (less than 12 months)No
2008-12-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017889-00
Policy instance 3
Insurance contract or identification number01-017889-00
Number of Individuals Covered284
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $13,199
Total amount of fees paid to insurance companyUSD $3,246
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 $91,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )
Policy contract number941
Policy instance 2
Insurance contract or identification number941
Number of Individuals Covered430
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $18,129
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
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: 53031 )
Policy contract number30044311
Policy instance 1
Insurance contract or identification number30044311
Number of Individuals Covered276
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,690
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,756
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 number01-017889-00
Policy instance 3
Insurance contract or identification number01-017889-00
Number of Individuals Covered268
Insurance policy start date2022-12-01
Insurance policy end date2022-12-31
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
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )
Policy contract number941
Policy instance 2
Insurance contract or identification number941
Number of Individuals Covered398
Insurance policy start date2022-12-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,672
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044311
Policy instance 1
Insurance contract or identification number30044311
Number of Individuals Covered247
Insurance policy start date2022-12-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $318
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,312
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: 53031 )
Policy contract number30044311
Policy instance 1
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )
Policy contract number941
Policy instance 2
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017889-00
Policy instance 3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017889-00
Policy instance 3
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )
Policy contract number941
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044311
Policy instance 1
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017889-00
Policy instance 3
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )
Policy contract number941
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044311
Policy instance 1

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