401k Plan data: MICHELIN RETIREE HEALTH PLAN plan

MICHELIN RETIREE HEALTH PLAN 401k Plan overview

Plan Name	MICHELIN RETIREE HEALTH PLAN
Plan identification number	602

MICHELIN RETIREE HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental

401k Sponsoring company profile

MICHELIN NORTH AMERICA, INC. has sponsored the creation of one or more 401k plans.

Company Name: MICHELIN NORTH AMERICA, INC.

Employer identification number (EIN): 111724631

NAIC Classification: 326200

Additional information about MICHELIN NORTH AMERICA, INC.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1950-12-28

Company Identification Number: 66186

Legal Registered Office Address: 28 LIBERTY ST.
New York
NEW YORK
United States of America (USA)
10005

More information about MICHELIN NORTH AMERICA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MICHELIN RETIREE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
602 2022-01-01
602 2021-01-01
602 2020-01-01
602 2019-01-01
602 2018-01-01
602 2017-01-01
602 2016-01-01
602 2015-01-01

Plan Statistics for MICHELIN RETIREE HEALTH PLAN

401k plan membership statisitcs for MICHELIN RETIREE HEALTH PLAN

Measure Date Value
2022: MICHELIN RETIREE HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,593
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 1,313
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 1,313
2021: MICHELIN RETIREE HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,414
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
Number of retired or separated participants receiving benefits 2021-01-01 1,593
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 1,593
2020: MICHELIN RETIREE HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,408
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 1,414
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 1,414
2019: MICHELIN RETIREE HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,013
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 1,408
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 1,408
2018: MICHELIN RETIREE HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 997
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1,013
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 1,013
2017: MICHELIN RETIREE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,381
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 997
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 997
2016: MICHELIN RETIREE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 6,232
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 6,084
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 6,084
2015: MICHELIN RETIREE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 6,659
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 6,232
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 6,232

Measure	Date	Value
2022: MICHELIN RETIREE HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,593
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	1,313
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	1,313
2021: MICHELIN RETIREE HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,414
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	1,593
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	1,593
2020: MICHELIN RETIREE HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,408
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	1,414
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	1,414
2019: MICHELIN RETIREE HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,013
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	1,408
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	1,408
2018: MICHELIN RETIREE HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	997
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,013
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	1,013
2017: MICHELIN RETIREE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,381
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	997
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	997
2016: MICHELIN RETIREE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	6,232
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	6,084
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	6,084
2015: MICHELIN RETIREE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	6,659
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	6,232
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	6,232

Form 5500 Responses for MICHELIN RETIREE HEALTH PLAN

2022: MICHELIN RETIREE HEALTH PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: MICHELIN RETIREE HEALTH PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: MICHELIN RETIREE HEALTH PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: MICHELIN RETIREE HEALTH PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: MICHELIN RETIREE HEALTH PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	Yes
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: MICHELIN RETIREE HEALTH PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: MICHELIN RETIREE HEALTH PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: MICHELIN RETIREE HEALTH PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

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

Policy contract number

0143169

Policy instance

Insurance contract or identification number	0143169
Number of Individuals Covered	1212
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $78,667
Total amount of fees paid to insurance company	USD $1,327
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 $506,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $78,667
Amount paid for insurance broker fees	1327
Additional information about fees paid to insurance broker	FEES PAID
Insurance broker organization code?	3

Potentially related plans

MICHELIN RETIREE HEALTH PLAN [EIN = 111727631]

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Company Name:	MICHELIN NORTH AMERICA, INC.
Employer identification number (EIN):	111724631
NAIC Classification:	326200

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1950-12-28
Company Identification Number:	66186
Legal Registered Office Address:	28 LIBERTY ST. New York NEW YORK United States of America (USA) 10005