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DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 401k Plan overview

Plan NameDESTINATION XL GROUP INC. HEALTH INSURANCE PLAN
Plan identification number 501

DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

DESTINATION XL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:DESTINATION XL GROUP, INC.
Employer identification number (EIN):042623104
NAIC Classification:448110
NAIC Description:Men's Clothing Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01ALAN F. TEIXEIRA
5012017-01-01ALAN F. TEIXEIRA
5012016-01-01ALAN F. TEIXEIRA ALAN F. TEIXEIRA2017-10-13
5012015-01-01ALAN F. TEIXEIRA
5012014-01-01ALAN F. TEIXEIRA
5012013-01-01ALAN F. TEIXEIRA
5012012-01-01ALAN TEIXEIRA ALAN TEIXEIRA2013-06-26
5012011-01-01ALAN TEIXEIRA ALAN TEIXEIRA2012-05-01
5012009-01-01ALAN TEIXEIRA ALAN TEIXEIRA2010-10-13
5012007-01-01ALAN F. TEIXEIRA ALAN F. TEIXEIRA2010-12-17
5012004-01-01ALAN F. TEIXEIRA ALAN F. TEIXEIRA2010-12-17

Plan Statistics for DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN

401k plan membership statisitcs for DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN

Measure Date Value
2022: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,102
Total number of active participants reported on line 7a of the Form 55002022-01-011,107
Number of retired or separated participants receiving benefits2022-01-014
Number of other retired or separated participants entitled to future benefits2022-01-0133
Total of all active and inactive participants2022-01-011,144
2021: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,374
Total number of active participants reported on line 7a of the Form 55002021-01-011,366
Number of retired or separated participants receiving benefits2021-01-0112
Number of other retired or separated participants entitled to future benefits2021-01-0125
Total of all active and inactive participants2021-01-011,403
2020: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,451
Total number of active participants reported on line 7a of the Form 55002020-01-011,352
Number of retired or separated participants receiving benefits2020-01-0122
Number of other retired or separated participants entitled to future benefits2020-01-01272
Total of all active and inactive participants2020-01-011,646
2019: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,530
Total number of active participants reported on line 7a of the Form 55002019-01-011,442
Number of retired or separated participants receiving benefits2019-01-019
Number of other retired or separated participants entitled to future benefits2019-01-012
Total of all active and inactive participants2019-01-011,453
2018: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,548
Total number of active participants reported on line 7a of the Form 55002018-01-011,459
Number of retired or separated participants receiving benefits2018-01-0119
Number of other retired or separated participants entitled to future benefits2018-01-0152
Total of all active and inactive participants2018-01-011,530
2017: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,489
Total number of active participants reported on line 7a of the Form 55002017-01-011,491
Number of retired or separated participants receiving benefits2017-01-0114
Number of other retired or separated participants entitled to future benefits2017-01-0143
Total of all active and inactive participants2017-01-011,548
2016: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,486
Total number of active participants reported on line 7a of the Form 55002016-01-011,489
Number of retired or separated participants receiving benefits2016-01-014
Number of other retired or separated participants entitled to future benefits2016-01-0117
Total of all active and inactive participants2016-01-011,510
2015: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01782
Total number of active participants reported on line 7a of the Form 55002015-01-01766
Number of retired or separated participants receiving benefits2015-01-0110
Number of other retired or separated participants entitled to future benefits2015-01-0135
Total of all active and inactive participants2015-01-01811
2014: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01742
Total number of active participants reported on line 7a of the Form 55002014-01-01729
Number of retired or separated participants receiving benefits2014-01-016
Number of other retired or separated participants entitled to future benefits2014-01-0147
Total of all active and inactive participants2014-01-01782
2013: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01735
Total number of active participants reported on line 7a of the Form 55002013-01-01721
Number of retired or separated participants receiving benefits2013-01-0121
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01742
2012: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01770
Total number of active participants reported on line 7a of the Form 55002012-01-01722
Number of retired or separated participants receiving benefits2012-01-0113
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01735
2011: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01913
Total number of active participants reported on line 7a of the Form 55002011-01-01770
Number of retired or separated participants receiving benefits2011-01-0118
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01788
2009: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01998
Total number of active participants reported on line 7a of the Form 55002009-01-01873
Number of retired or separated participants receiving benefits2009-01-0135
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01908
2007: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-011,137
Total number of active participants reported on line 7a of the Form 55002007-01-01995
Number of retired or separated participants receiving benefits2007-01-0130
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-011,025
2004: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-011,051
Total number of active participants reported on line 7a of the Form 55002004-01-011,051
Number of retired or separated participants receiving benefits2004-01-010
Number of other retired or separated participants entitled to future benefits2004-01-010
Total of all active and inactive participants2004-01-011,051

Form 5500 Responses for DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN

2022: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: DESTINATION XL GROUP INC. HEALTH INSURANCE 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 filingNo
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 – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: DESTINATION XL GROUP INC. HEALTH INSURANCE 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 – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: DESTINATION XL GROUP INC. HEALTH INSURANCE 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 – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2007: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedYes
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – General assets of the sponsorYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – General assets of the sponsorYes
2004: DESTINATION XL GROUP INC. HEALTH INSURANCE PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedYes
2004-01-01This submission is the final filingNo
2004-01-01This return/report is a short plan year return/report (less than 12 months)No
2004-01-01Plan is a collectively bargained planNo
2004-01-01Plan funding arrangement – General assets of the sponsorYes
2004-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9659970
Policy instance 1
Insurance contract or identification number9659970
Number of Individuals Covered1238
Insurance policy start date2007-01-01
Insurance policy end date2007-12-31
Total amount of commissions paid to insurance brokerUSD $1,871
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $60,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,871
Insurance broker organization code?3
Insurance broker nameWILLIS OF MASSACHUSETTS
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9659970
Policy instance 1
Insurance contract or identification number9659970
Number of Individuals Covered664
Insurance policy start date2006-01-01
Insurance policy end date2006-12-31
Total amount of commissions paid to insurance brokerUSD $1,309
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $33,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,309
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberST-0100-1524
Policy instance 1
Insurance contract or identification numberST-0100-1524
Number of Individuals Covered17
Insurance policy start date2003-01-01
Insurance policy end date2003-12-31
Total amount of commissions paid to insurance brokerUSD $1,055
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $21,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,055
Insurance broker organization code?3
Insurance broker nameMARSH USA, INC.

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