401k Plan data: NICOLIA INDUSTRIES, INC. MEDICAL PLAN plan

NICOLIA INDUSTRIES, INC. MEDICAL PLAN 401k Plan overview

Plan Name	NICOLIA INDUSTRIES, INC. MEDICAL PLAN
Plan identification number	501

NICOLIA INDUSTRIES, INC. MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance) Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

NICOLIA INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name: NICOLIA INDUSTRIES, INC.

Employer identification number (EIN): 113308897

NAIC Classification: 327300

Additional information about NICOLIA INDUSTRIES, INC.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1996-01-03

Company Identification Number: 1986983

Legal Registered Office Address: 612 MUNCY AVENUE
Suffolk
LINDENHURST
United States of America (USA)
11757

More information about NICOLIA INDUSTRIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NICOLIA INDUSTRIES, INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 MICHAEL IPPOLITO 2023-10-12
501 2016-01-01 MARIANNE THEISEN
501 2015-01-01
501 2014-01-01 ROBERTO NICOLIA
501 2013-01-01 ROBERTO NICOLIA
501 2012-01-01 ROBERTO NICOLIA
501 2011-01-01 ROBERTO NICOLIA

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2022-01-01	MICHAEL IPPOLITO	2023-10-12
501	2016-01-01	MARIANNE THEISEN
501	2015-01-01
501	2014-01-01	ROBERTO NICOLIA
501	2013-01-01	ROBERTO NICOLIA
501	2012-01-01	ROBERTO NICOLIA
501	2011-01-01	ROBERTO NICOLIA

Plan Statistics for NICOLIA INDUSTRIES, INC. MEDICAL PLAN

401k plan membership statisitcs for NICOLIA INDUSTRIES, INC. MEDICAL PLAN

Measure Date Value
2022: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 225
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 225
Number of employers contributing to the scheme 2022-01-01 0
2016: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 121
Number of retired or separated participants receiving benefits 2016-01-01 2
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 123
2015: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 101
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 120
Number of retired or separated participants receiving benefits 2015-01-01 3
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 123
2014: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 107
Number of retired or separated participants receiving benefits 2014-01-01 2
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 109
2013: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 109
Number of retired or separated participants receiving benefits 2013-01-01 2
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 111
2012: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 148
Number of retired or separated participants receiving benefits 2012-01-01 2
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 150
2011: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 254
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 255

Measure	Date	Value
2022: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	225
Number of retired or separated participants receiving benefits	2022-01-01	0
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	225
Number of employers contributing to the scheme	2022-01-01	0
2016: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	121
Number of retired or separated participants receiving benefits	2016-01-01	2
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	123
2015: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	101
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	120
Number of retired or separated participants receiving benefits	2015-01-01	3
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	123
2014: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	107
Number of retired or separated participants receiving benefits	2014-01-01	2
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	109
2013: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	109
Number of retired or separated participants receiving benefits	2013-01-01	2
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	111
2012: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	148
Number of retired or separated participants receiving benefits	2012-01-01	2
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	150
2011: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	254
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	255

Form 5500 Responses for NICOLIA INDUSTRIES, INC. MEDICAL PLAN

2022: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2016: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
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 benefit arrangement – Insurance	Yes
2015: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
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 benefit arrangement – Insurance	Yes
2014: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: NICOLIA INDUSTRIES, INC. MEDICAL PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

625215

Policy instance

Insurance contract or identification number	625215
Number of Individuals Covered	126
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $64,412
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,064,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	43945
Additional information about fees paid to insurance broker	BENEFIT ADVISOR FEE, INCENTIVE COMPENSATION
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLY960571

Policy instance

Insurance contract or identification number	FLY960571
Number of Individuals Covered	225
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life 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

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:	NICOLIA INDUSTRIES, INC.
Employer identification number (EIN):	113308897
NAIC Classification:	327300

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1996-01-03
Company Identification Number:	1986983
Legal Registered Office Address:	612 MUNCY AVENUE Suffolk LINDENHURST United States of America (USA) 11757