401k Plan data: AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN plan

AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN 401k Plan overview

Plan Name	AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN
Plan identification number	502

AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH 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 Other welfare benefit cover

401k Sponsoring company profile

AMERICAN ROLLER BEARING INC. has sponsored the creation of one or more 401k plans.

Company Name: AMERICAN ROLLER BEARING INC.

Employer identification number (EIN): 921443732

NAIC Classification: 332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2023-02-01

Plan Statistics for AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN

401k plan membership statisitcs for AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN

Measure Date Value
2023: AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN 2023 401k membership
Total participants, beginning-of-year 2023-02-01 214
Total number of active participants reported on line 7a of the Form 5500 2023-02-01 214
Number of retired or separated participants receiving benefits 2023-02-01 0
Number of other retired or separated participants entitled to future benefits 2023-02-01 0
Total of all active and inactive participants 2023-02-01 214

Measure	Date	Value
2023: AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN 2023 401k membership
Total participants, beginning-of-year	2023-02-01	214
Total number of active participants reported on line 7a of the Form 5500	2023-02-01	214
Number of retired or separated participants receiving benefits	2023-02-01	0
Number of other retired or separated participants entitled to future benefits	2023-02-01	0
Total of all active and inactive participants	2023-02-01	214

Form 5500 Responses for AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN

2023: AMERICAN ROLLER BEARING INC. EMPLOYEE HEALTH PLAN 2023 form 5500 responses
2023-02-01	Type of plan entity	Single employer plan
2023-02-01	Submission has been amended	No
2023-02-01	This submission is the final filing	No
2023-02-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2023-02-01	Plan is a collectively bargained plan	No
2023-02-01	Plan funding arrangement – Insurance	Yes
2023-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-02-01	Plan benefit arrangement – Insurance	Yes
2023-02-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

ONE AMERICA (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G 00613103

Policy instance

Insurance contract or identification number	G 00613103
Number of Individuals Covered	214
Insurance policy start date	2023-02-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $375
Total amount of fees paid to insurance company	USD $193
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D, VOL AD&D, VOL LIFE
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $12,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $375
Insurance broker organization code?	3
Amount paid for insurance broker fees	193
Additional information about fees paid to insurance broker	OTHER COMPENSATION

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Company Name:	AMERICAN ROLLER BEARING INC.
Employer identification number (EIN):	921443732
NAIC Classification:	332900