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AM LITHOGRAPHY HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameAM LITHOGRAPHY HEALTH AND WELFARE PLAN
Plan identification number 503

AM LITHOGRAPHY HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

A.M. LITHOGRAPHY has sponsored the creation of one or more 401k plans.

Company Name:A.M. LITHOGRAPHY
Employer identification number (EIN):042987023
NAIC Classification:323100

Additional information about A.M. LITHOGRAPHY

Jurisdiction of Incorporation: Commonwealth of Massachusetts Corporations Division
Incorporation Date:
Company Identification Number: 042987023

More information about A.M. LITHOGRAPHY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AM LITHOGRAPHY HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-03-01MICHAEL HARRIS2023-09-18
5032021-03-01MIKE HARRIS2022-09-06
5032020-03-01MIKE HARRIS2022-08-02

Plan Statistics for AM LITHOGRAPHY HEALTH AND WELFARE PLAN

401k plan membership statisitcs for AM LITHOGRAPHY HEALTH AND WELFARE PLAN

Measure Date Value
2022: AM LITHOGRAPHY HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-03-01114
Total number of active participants reported on line 7a of the Form 55002022-03-01109
Number of retired or separated participants receiving benefits2022-03-010
Number of other retired or separated participants entitled to future benefits2022-03-010
Total of all active and inactive participants2022-03-01109
Number of employers contributing to the scheme2022-03-010
2021: AM LITHOGRAPHY HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-03-01114
Total number of active participants reported on line 7a of the Form 55002021-03-01114
Number of retired or separated participants receiving benefits2021-03-010
Number of other retired or separated participants entitled to future benefits2021-03-010
Total of all active and inactive participants2021-03-01114
Number of employers contributing to the scheme2021-03-010
2020: AM LITHOGRAPHY HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-03-01114
Total number of active participants reported on line 7a of the Form 55002020-03-01114
Number of retired or separated participants receiving benefits2020-03-010
Number of other retired or separated participants entitled to future benefits2020-03-010
Total of all active and inactive participants2020-03-01114
Number of employers contributing to the scheme2020-03-010

Form 5500 Responses for AM LITHOGRAPHY HEALTH AND WELFARE PLAN

2022: AM LITHOGRAPHY HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: AM LITHOGRAPHY HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: AM LITHOGRAPHY HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01First time form 5500 has been submittedYes
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 )
Policy contract number118223
Policy instance 1
Insurance contract or identification number118223
Number of Individuals Covered92
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $32,353
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $824,751
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $32,353
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number938939
Policy instance 2
Insurance contract or identification number938939
Number of Individuals Covered69
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $1,577
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,577
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10268547
Policy instance 3
Insurance contract or identification number10268547
Number of Individuals Covered109
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $378
Total amount of fees paid to insurance companyUSD $29
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $378
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBROKER BONUS
HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 )
Policy contract number118223
Policy instance 1
Insurance contract or identification number118223
Number of Individuals Covered76
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $34,278
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $879,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $34,278
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number938939
Policy instance 2
Insurance contract or identification number938939
Number of Individuals Covered68
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $1,942
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,942
Amount paid for insurance broker fees0
Insurance broker organization code?3
HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 )
Policy contract number118223
Policy instance 1
Insurance contract or identification number118223
Number of Individuals Covered79
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $38,283
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $853,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $38,283
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number938939
Policy instance 2
Insurance contract or identification number938939
Number of Individuals Covered66
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $1,361
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,361
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10260997
Policy instance 3
Insurance contract or identification number10260997
Number of Individuals Covered113
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $1,685
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,685
Amount paid for insurance broker fees0
Insurance broker organization code?3

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