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ARLINGTON COAL & LUMBER CO. MEDICAL PLAN 401k Plan overview

Plan NameARLINGTON COAL & LUMBER CO. MEDICAL PLAN
Plan identification number 506

ARLINGTON COAL & LUMBER CO. MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

ARLINGTON COAL & LUMBER COMPANY has sponsored the creation of one or more 401k plans.

Company Name:ARLINGTON COAL & LUMBER COMPANY
Employer identification number (EIN):041040820
NAIC Classification:444190
NAIC Description:Other Building Material Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ARLINGTON COAL & LUMBER CO. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062022-06-15JOHN BURKE2023-12-03
5062021-06-15JOHN BURKE2022-10-25

Plan Statistics for ARLINGTON COAL & LUMBER CO. MEDICAL PLAN

401k plan membership statisitcs for ARLINGTON COAL & LUMBER CO. MEDICAL PLAN

Measure Date Value
2022: ARLINGTON COAL & LUMBER CO. MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-15100
Total number of active participants reported on line 7a of the Form 55002022-06-1592
Number of retired or separated participants receiving benefits2022-06-150
Number of other retired or separated participants entitled to future benefits2022-06-150
Total of all active and inactive participants2022-06-1592
Number of employers contributing to the scheme2022-06-150
2021: ARLINGTON COAL & LUMBER CO. MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-15100
Total number of active participants reported on line 7a of the Form 55002021-06-1593
Number of retired or separated participants receiving benefits2021-06-150
Number of other retired or separated participants entitled to future benefits2021-06-150
Total of all active and inactive participants2021-06-1593
Number of employers contributing to the scheme2021-06-150

Form 5500 Responses for ARLINGTON COAL & LUMBER CO. MEDICAL PLAN

2022: ARLINGTON COAL & LUMBER CO. MEDICAL PLAN 2022 form 5500 responses
2022-06-15Type of plan entitySingle employer plan
2022-06-15Plan funding arrangement – InsuranceYes
2022-06-15Plan benefit arrangement – InsuranceYes
2021: ARLINGTON COAL & LUMBER CO. MEDICAL PLAN 2021 form 5500 responses
2021-06-15Type of plan entitySingle employer plan
2021-06-15First time form 5500 has been submittedYes
2021-06-15Plan funding arrangement – InsuranceYes
2021-06-15Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number55337000
Policy instance 1
Insurance contract or identification number55337000
Number of Individuals Covered217
Insurance policy start date2022-06-15
Insurance policy end date2023-06-14
Total amount of commissions paid to insurance brokerUSD $31,502
Total amount of fees paid to insurance companyUSD $12,423
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,117,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,502
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
Policy contract number55337000
Policy instance 1
Insurance contract or identification number55337000
Number of Individuals Covered218
Insurance policy start date2021-06-15
Insurance policy end date2022-06-14
Total amount of commissions paid to insurance brokerUSD $61,967
Total amount of fees paid to insurance companyUSD $12,423
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,049,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,415
Amount paid for insurance broker fees12423
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3

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