401k Plan data: LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN plan

LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN
Plan identification number	501

LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

LAWTON WELDING CO., INC. has sponsored the creation of one or more 401k plans.

Company Name: LAWTON WELDING CO., INC.

Employer identification number (EIN): 043251635

NAIC Classification: 332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-05-15

Plan Statistics for LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN

Measure Date Value
2022: LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-05-15 109
Total number of active participants reported on line 7a of the Form 5500 2022-05-15 123
Number of retired or separated participants receiving benefits 2022-05-15 0
Number of other retired or separated participants entitled to future benefits 2022-05-15 0
Total of all active and inactive participants 2022-05-15 123

Measure	Date	Value
2022: LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-05-15	109
Total number of active participants reported on line 7a of the Form 5500	2022-05-15	123
Number of retired or separated participants receiving benefits	2022-05-15	0
Number of other retired or separated participants entitled to future benefits	2022-05-15	0
Total of all active and inactive participants	2022-05-15	123

Form 5500 Responses for LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN

2022: LAWTON WELDING CO., INC. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-05-15	Type of plan entity	Single employer plan
2022-05-15	First time form 5500 has been submitted	Yes
2022-05-15	Submission has been amended	No
2022-05-15	This submission is the final filing	No
2022-05-15	This return/report is a short plan year return/report (less than 12 months)	No
2022-05-15	Plan is a collectively bargained plan	No
2022-05-15	Plan funding arrangement – Insurance	Yes
2022-05-15	Plan funding arrangement – General assets of the sponsor	Yes
2022-05-15	Plan benefit arrangement – Insurance	Yes
2022-05-15	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

661759

Policy instance

Insurance contract or identification number	661759
Number of Individuals Covered	123
Insurance policy start date	2022-05-01
Insurance policy end date	2023-04-30
Total amount of commissions paid to insurance broker	USD $270
Total amount of fees paid to insurance company	USD $47
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	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 $2,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $308
Amount paid for insurance broker fees	47
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00020505

Policy instance

Insurance contract or identification number	00020505
Number of Individuals Covered	57
Insurance policy start date	2022-05-01
Insurance policy end date	2023-04-30
Total amount of commissions paid to insurance broker	USD $5,870
Total amount of fees paid to insurance company	USD $2,551
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	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $51,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,774
Amount paid for insurance broker fees	2551
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )

Policy contract number

107309

Policy instance

Insurance contract or identification number	107309
Number of Individuals Covered	117
Insurance policy start date	2022-05-01
Insurance policy end date	2023-04-30
Total amount of commissions paid to insurance broker	USD $29,010
Total amount of fees paid to insurance company	USD $0
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	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $665,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $29,010
Insurance broker organization code?	3

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Company Name:	LAWTON WELDING CO., INC.
Employer identification number (EIN):	043251635
NAIC Classification:	332900