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MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameMISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 501

MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

MISSOURI WALNUT, LLC has sponsored the creation of one or more 401k plans.

Company Name:MISSOURI WALNUT, LLC
Employer identification number (EIN):200080422
NAIC Classification:423300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01TIMOTHY MOHS

Plan Statistics for MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2022: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01140
Total number of active participants reported on line 7a of the Form 55002022-01-01157
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01158
2021: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01164
Total number of active participants reported on line 7a of the Form 55002021-01-01137
Number of retired or separated participants receiving benefits2021-01-013
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01140
2020: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01161
Total number of active participants reported on line 7a of the Form 55002020-01-01164
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01164
2019: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01159
Total number of active participants reported on line 7a of the Form 55002019-01-01161
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01161
2018: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01152
Total number of active participants reported on line 7a of the Form 55002018-01-01159
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 participants2018-01-01159

Form 5500 Responses for MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN

2022: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: MISSOURI WALNUT HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number922713
Policy instance 4
Insurance contract or identification number922713
Number of Individuals Covered156
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,493
Total amount of fees paid to insurance companyUSD $326
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, AD&D, AND CRITICAL ILLNES
Welfare Benefit Premiums Paid to CarrierUSD $116,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,493
Insurance broker organization code?3
Amount paid for insurance broker fees326
Additional information about fees paid to insurance brokerBONUS
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number01190330
Policy instance 3
Insurance contract or identification number01190330
Number of Individuals Covered157
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $5,439
Total amount of fees paid to insurance companyUSD $239
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,439
Amount paid for insurance broker fees239
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
ADVANTICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12278 )
Policy contract number19010701
Policy instance 2
Insurance contract or identification number19010701
Number of Individuals Covered121
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $645
Total amount of fees paid to insurance companyUSD $51
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $645
Amount paid for insurance broker fees51
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number919788
Policy instance 1
Insurance contract or identification number919788
Number of Individuals Covered153
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $21,164
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $641,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees21164
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0919788
Policy instance 1
Insurance contract or identification number0919788
Number of Individuals Covered69
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $20,702
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $600,979
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees20702
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
ADVANTICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12278 )
Policy contract number19010701
Policy instance 2
Insurance contract or identification number19010701
Number of Individuals Covered113
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $649
Total amount of fees paid to insurance companyUSD $59
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $649
Amount paid for insurance broker fees59
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number01190330
Policy instance 3
Insurance contract or identification number01190330
Number of Individuals Covered137
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,280
Total amount of fees paid to insurance companyUSD $299
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,280
Amount paid for insurance broker fees299
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number922713
Policy instance 4
Insurance contract or identification number922713
Number of Individuals Covered200
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $11,773
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, AD&D, AND CRITICAL ILLNES
Welfare Benefit Premiums Paid to CarrierUSD $100,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,773
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number922713
Policy instance 4
Insurance contract or identification number922713
Number of Individuals Covered193
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,003
Total amount of fees paid to insurance companyUSD $2,271
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, AD&D, AND CRITICAL ILLNES
Welfare Benefit Premiums Paid to CarrierUSD $126,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,003
Amount paid for insurance broker fees2271
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number01190330
Policy instance 3
Insurance contract or identification number01190330
Number of Individuals Covered164
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,345
Total amount of fees paid to insurance companyUSD $317
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,345
Amount paid for insurance broker fees317
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
ADVANTICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12278 )
Policy contract number19010701
Policy instance 2
Insurance contract or identification number19010701
Number of Individuals Covered149
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $870
Total amount of fees paid to insurance companyUSD $58
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $870
Amount paid for insurance broker fees58
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0919788
Policy instance 1
Insurance contract or identification number0919788
Number of Individuals Covered116
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $24,706
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $753,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees24706
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5467291
Policy instance 1
Insurance contract or identification number5467291
Number of Individuals Covered160
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9,882
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS AND AD&D
Welfare Benefit Premiums Paid to CarrierUSD $82,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,868
Insurance broker organization code?3
HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract numberW60428
Policy instance 2
Insurance contract or identification numberW60428
Number of Individuals Covered153
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $22,286
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $715,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,286
Insurance broker organization code?3
ADVANTICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12278 )
Policy contract number19010701
Policy instance 3
Insurance contract or identification number19010701
Number of Individuals Covered119
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $628
Total amount of fees paid to insurance companyUSD $9
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $628
Amount paid for insurance broker fees9
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number01190330
Policy instance 4
Insurance contract or identification number01190330
Number of Individuals Covered137
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,523
Total amount of fees paid to insurance companyUSD $29
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,523
Amount paid for insurance broker fees29
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number922713
Policy instance 5
Insurance contract or identification number922713
Number of Individuals Covered161
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,445
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,445
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00247249
Policy instance 3
Insurance contract or identification number00247249
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract number00247249
Policy instance 2
Insurance contract or identification number00247249
Number of Individuals Covered139
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,526
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $604,576
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,028
Insurance broker organization code?3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5467291
Policy instance 1
Insurance contract or identification number5467291
Number of Individuals Covered171
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $10,916
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS AND AD&D
Welfare Benefit Premiums Paid to CarrierUSD $91,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,575
Insurance broker organization code?3

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