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UNIVERA HEALTH INSURANCE PLAN 401k Plan overview

Plan NameUNIVERA HEALTH INSURANCE PLAN
Plan identification number 503

UNIVERA HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

DIVERSIFIED MANUFACTURING, INC. has sponsored the creation of one or more 401k plans.

Company Name:DIVERSIFIED MANUFACTURING, INC.
Employer identification number (EIN):161478631
NAIC Classification:332700

Additional information about DIVERSIFIED MANUFACTURING, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2129385

More information about DIVERSIFIED MANUFACTURING, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNIVERA HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032015-01-01WALTER E. KEMPA, JR. WALTER E. KEMPA, JR.2016-07-28
5032014-01-01WALTER E. KEMPA, JR. WALTER E. KEMPA, JR.2015-05-21
5032013-01-01WALTER E. KEMPA, JR. WALTER E. KEMPA, JR.2014-05-28
5032012-01-01WALTER E. KEMPA, JR. WALTER E. KEMPA, JR.2013-06-06
5032009-01-01WALTER E. KEMPA, JR. WALTER E. KEMPA, JR.2010-07-16

Plan Statistics for UNIVERA HEALTH INSURANCE PLAN

401k plan membership statisitcs for UNIVERA HEALTH INSURANCE PLAN

Measure Date Value
2015: UNIVERA HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01105
Total number of active participants reported on line 7a of the Form 55002015-01-0191
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 participants2015-01-0191
2014: UNIVERA HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01115
Total number of active participants reported on line 7a of the Form 55002014-01-01105
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01105
2013: UNIVERA HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01116
Total number of active participants reported on line 7a of the Form 55002013-01-01115
Total of all active and inactive participants2013-01-01115
2012: UNIVERA HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01107
Total number of active participants reported on line 7a of the Form 55002012-01-01116
Total of all active and inactive participants2012-01-01116
2009: UNIVERA HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01106
Total number of active participants reported on line 7a of the Form 55002009-01-0171
Total of all active and inactive participants2009-01-0171

Form 5500 Responses for UNIVERA HEALTH INSURANCE PLAN

2015: UNIVERA HEALTH INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: UNIVERA HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: UNIVERA HEALTH INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: UNIVERA HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2009: UNIVERA HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01First time form 5500 has been submittedYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 )
Policy contract number32868
Policy instance 1
Insurance contract or identification number32868
Number of Individuals Covered206
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $30,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,851
Insurance broker organization code?3
Insurance broker nameNIAGARA NATIONAL INC
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract numberWFPALLMRP03909
Policy instance 1
Insurance contract or identification numberWFPALLMRP03909
Number of Individuals Covered105
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $45,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,599
Insurance broker organization code?3
Insurance broker nameNIAGARA NATIONAL INC.
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract numberWFPALLMRP03909
Policy instance 1
Insurance contract or identification numberWFPALLMRP03909
Number of Individuals Covered116
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $42,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,910
Insurance broker organization code?3
Insurance broker nameNIAGARA NATIONAL INC.
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract numberWFPALLMRP03909
Policy instance 1
Insurance contract or identification numberWFPALLMRP03909
Number of Individuals Covered116
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $41,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,958
Insurance broker organization code?3
Insurance broker nameNIAGARA NATIONAL INC.

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