401k Plan data: SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN plan

SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN 401k Plan overview

Plan Name	SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN
Plan identification number	514

SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

SAMUEL SON & CO (USA) INC. 401K has sponsored the creation of one or more 401k plans.

Company Name: SAMUEL SON & CO (USA) INC. 401K

Employer identification number (EIN): 061251791

NAIC Classification: 332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
514 2019-01-01
514 2019-01-01 JAMES FUDACZ 2021-09-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
514	2019-01-01
514	2019-01-01	JAMES FUDACZ	2021-09-13

Plan Statistics for SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN

401k plan membership statisitcs for SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN

Measure Date Value
2019: SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 2,193
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 3,650
Total of all active and inactive participants 2019-01-01 3,650
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Number of employers contributing to the scheme 2019-01-01 0

Measure	Date	Value
2019: SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	2,193
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	3,650
Total of all active and inactive participants	2019-01-01	3,650
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Number of employers contributing to the scheme	2019-01-01	0

Form 5500 Responses for SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN

2019: SAMUEL, SON & CO. (USA) INC. AD&D/LIFE PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	This submission is the final filing	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0213116

Policy instance

Insurance contract or identification number	0213116
Number of Individuals Covered	2931
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $305,749
Total amount of fees paid to insurance company	USD $136,267
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $189,533
Amount paid for insurance broker fees	10015
Insurance broker organization code?	3

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

Policy contract number

00507652

Policy instance

Insurance contract or identification number	00507652
Number of Individuals Covered	172
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $12,114
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $226,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,323
Insurance broker organization code?	3

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )

Policy contract number

01-015007-00

Policy instance

Insurance contract or identification number	01-015007-00
Number of Individuals Covered	547
Insurance policy start date	2019-02-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,900
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $17,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,900
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

213116

Policy instance

Insurance contract or identification number	213116
Number of Individuals Covered	2931
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $305,749
Total amount of fees paid to insurance company	USD $136,267
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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

Policy contract number

507652

Policy instance

Insurance contract or identification number	507652
Number of Individuals Covered	172
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $12,114
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $226,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	SAMUEL SON & CO (USA) INC. 401K
Employer identification number (EIN):	061251791
NAIC Classification:	332900