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SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN 401k Plan overview

Plan NameSIMONA AMERICA, INC. LIFE AND DISABILITY PLAN
Plan identification number 523

SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

SIMONA AMERICA GROUP INC. has sponsored the creation of one or more 401k plans.

Company Name:SIMONA AMERICA GROUP INC.
Employer identification number (EIN):134269250
NAIC Classification:326100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5232018-01-01ANNA RINALDI
5232017-01-01
5232016-01-01MICHELLE MCGOUGH
5232015-01-01MICHELLE MCGOUGH

Plan Statistics for SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN

401k plan membership statisitcs for SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN

Measure Date Value
2018: SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01210
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-010
2017: SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01242
Total number of active participants reported on line 7a of the Form 55002017-01-01210
Total of all active and inactive participants2017-01-01210
Total participants2017-01-01210
2016: SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01245
Total number of active participants reported on line 7a of the Form 55002016-01-01207
Number of retired or separated participants receiving benefits2016-01-0135
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01242
2015: SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01133
Total number of active participants reported on line 7a of the Form 55002015-01-01212
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01212

Form 5500 Responses for SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN

2018: SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingYes
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: SIMONA AMERICA, INC. LIFE AND DISABILITY PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10093744
Policy instance 1
Insurance contract or identification number10093744
Number of Individuals Covered210
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,514
Total amount of fees paid to insurance companyUSD $700
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,928
Amount paid for insurance broker fees700
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES, INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10093745
Policy instance 2
Insurance contract or identification number10093745
Number of Individuals Covered100
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10093743
Policy instance 3
Insurance contract or identification number10093743
Number of Individuals Covered210
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,332
Total amount of fees paid to insurance companyUSD $560
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $26,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,249
Amount paid for insurance broker fees560
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES, INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 20939
Policy instance 4
Insurance contract or identification number400001000 20939
Number of Individuals Covered104
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,338
Total amount of fees paid to insurance companyUSD $696
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $31,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,438
Amount paid for insurance broker fees696
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES, INC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3310554
Policy instance 5
Insurance contract or identification numberE3310554
Number of Individuals Covered8
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $392
Other welfare benefits providedWHOLE/TERM LIFE, STD, ACC, CI, CA
Welfare Benefit Premiums Paid to CarrierUSD $3,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $231
Insurance broker organization code?3
Insurance broker nameDAN YAARY
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJTB85
Policy instance 6
Insurance contract or identification numberJTB85
Number of Individuals Covered31
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,973
Total amount of fees paid to insurance companyUSD $775
Other welfare benefits providedACC, CA, CC, HOSP, LIFE, DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $20,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,938
Amount paid for insurance broker fees543
Insurance broker organization code?3
Insurance broker nameJOSEPH B MCGINTY JR
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJTB87
Policy instance 7
Insurance contract or identification numberJTB87
Number of Individuals Covered4
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,013
Total amount of fees paid to insurance companyUSD $117
Other welfare benefits providedACC, CA, CC, HOSP, LIFE, DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $5,563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $825
Amount paid for insurance broker fees83
Insurance broker organization code?3
Insurance broker nameJOSEPH B MCGINTY JR

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