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SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 401k Plan overview

Plan NameSIMON PEARCE US INC. EE BENEFIT HEALTH PLAN
Plan identification number 502

SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

SIMON PEARCE US INC. has sponsored the creation of one or more 401k plans.

Company Name:SIMON PEARCE US INC.
Employer identification number (EIN):030278920
NAIC Classification:327210

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022015-01-01CATHY SULLIVAN CATHY SULLIVAN2016-05-17
5022014-01-01CATHY SULLIVAN CATHY SULLIVAN2015-07-06
5022013-01-01CATHY SULLIVAN CATHY SULLIVAN2014-07-25
5022012-01-01CATHY SULLIVAN
5022011-01-01CATHY SULLIVAN
5022010-01-01CATHY SULLIVAN
5022009-01-01CATHY SULLIVAN

Plan Statistics for SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN

401k plan membership statisitcs for SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN

Measure Date Value
2015: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01199
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
2014: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01183
Total number of active participants reported on line 7a of the Form 55002014-01-01173
Number of retired or separated participants receiving benefits2014-01-015
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01178
2013: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01158
Total number of active participants reported on line 7a of the Form 55002013-01-01169
Number of retired or separated participants receiving benefits2013-01-013
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01172
2012: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01153
Total number of active participants reported on line 7a of the Form 55002012-01-01152
Number of retired or separated participants receiving benefits2012-01-016
Total of all active and inactive participants2012-01-01158
Total participants2012-01-010
2011: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01167
Total number of active participants reported on line 7a of the Form 55002011-01-01153
Number of retired or separated participants receiving benefits2011-01-016
Total of all active and inactive participants2011-01-01159
Total participants2011-01-01159
2010: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01167
Total number of active participants reported on line 7a of the Form 55002010-01-01167
Number of retired or separated participants receiving benefits2010-01-0114
Total of all active and inactive participants2010-01-01181
Total participants2010-01-01181
2009: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01193
Total number of active participants reported on line 7a of the Form 55002009-01-01167
Number of retired or separated participants receiving benefits2009-01-0114
Total of all active and inactive participants2009-01-01181
Total participants2009-01-01181

Form 5500 Responses for SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN

2015: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingYes
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: SIMON PEARCE US INC. EE BENEFIT HEALTH PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30045226
Policy instance 1
Insurance contract or identification number30045226
Number of Individuals Covered155
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,241
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,241
Insurance broker organization code?3
Insurance broker nameTHE RICHARDS GROUP
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number
Policy instance 1
Number of Individuals Covered192
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $185,415
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $275,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees143167
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameTHE RICHARDS GROUP
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30045226
Policy instance 2
Insurance contract or identification number30045226
Number of Individuals Covered148
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,202
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,202
Insurance broker organization code?3
Insurance broker nameTHE RICHARDS GROUP
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3313684
Policy instance 1
Insurance contract or identification number3313684
Number of Individuals Covered391
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $38,436
Total amount of fees paid to insurance companyUSD $2,371
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $323,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,436
Amount paid for insurance broker fees2371
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
Insurance broker nameHICKOK AND BOARDMAN FINANCIAL
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3313684
Policy instance 1
Insurance contract or identification number3313684
Number of Individuals Covered351
Total amount of commissions paid to insurance brokerUSD $29,852
Total amount of fees paid to insurance companyUSD $1,962
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $260,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,852
Amount paid for insurance broker fees1962
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
Insurance broker nameHICKOK & BOARDMAN FINANCIAL
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3313684
Policy instance 1
Insurance contract or identification number3313684
Number of Individuals Covered350
Total amount of commissions paid to insurance brokerUSD $31,534
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $237,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3313684
Policy instance 1
Insurance contract or identification number3313684
Number of Individuals Covered351
Total amount of commissions paid to insurance brokerUSD $28,759
Total amount of fees paid to insurance companyUSD $2,030
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $220,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,759
Amount paid for insurance broker fees2030
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
Insurance broker nameHICKOK & BOARDMAN FINANCIAL

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