MITAS TIRES OF NORTH AMERICA VISION PLAN 401k Plan overview
| Plan Name | MITAS TIRES OF NORTH AMERICA VISION PLAN |
| Plan identification number | 504 |
MITAS TIRES OF NORTH AMERICA VISION PLAN Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Vision
- Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
- 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.
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401k Sponsoring company profile
MITAS TIRES NORTH AMERICA, INC. has sponsored the creation of one or more 401k plans.
Additional information about MITAS TIRES NORTH AMERICA, INC.
| Jurisdiction of Incorporation: | State of Delaware Division of Corporations |
| Incorporation Date: | |
| Company Identification Number: | 3185723 |
More information about MITAS TIRES NORTH AMERICA, INC.
Form 5500 Filing Information
Submission information for form 5500 for 401k plan MITAS TIRES OF NORTH AMERICA VISION PLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 504 | 2017-04-01 | | | | |
| 504 | 2014-04-01 | DIANNE POOLE | | | |
Plan Statistics for MITAS TIRES OF NORTH AMERICA VISION PLAN
401k plan membership statisitcs for MITAS TIRES OF NORTH AMERICA VISION PLAN
| Measure | Date | Value |
|---|
| 2017: MITAS TIRES OF NORTH AMERICA VISION PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 100 |
| Number of retired or separated participants receiving benefits | 2017-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-04-01 | 0 |
| Total of all active and inactive participants | 2017-04-01 | 100 |
| 2014: MITAS TIRES OF NORTH AMERICA VISION PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 93 |
| Number of retired or separated participants receiving benefits | 2014-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-04-01 | 0 |
| Total of all active and inactive participants | 2014-04-01 | 93 |
Form 5500 Responses for MITAS TIRES OF NORTH AMERICA VISION PLAN
| 2017: MITAS TIRES OF NORTH AMERICA VISION PLAN 2017 form 5500 responses |
|---|
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: MITAS TIRES OF NORTH AMERICA VISION PLAN 2014 form 5500 responses |
|---|
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | First time form 5500 has been submitted | Yes |
| 2014-04-01 | Submission has been amended | No |
| 2014-04-01 | This submission is the final filing | No |
| 2014-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-04-01 | Plan is a collectively bargained plan | No |
| 2014-04-01 | Plan funding arrangement – Insurance | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30035935 |
| Policy instance | 1 |
| Insurance contract or identification number | 30035935 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $1,224 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,931 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,224 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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