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CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN 401k Plan overview

Plan NameCARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN
Plan identification number 501

CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CARLSON ENVIRONMENTAL CONSULTANTS has sponsored the creation of one or more 401k plans.

Company Name:CARLSON ENVIRONMENTAL CONSULTANTS
Employer identification number (EIN):200471138
NAIC Classification:541330
NAIC Description:Engineering Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01KRISTOFER CARLSON2023-10-16
5012021-04-01KRISTOFER CARLSON2022-10-26
5012020-04-01KRISTOFER CARLSON2021-09-21
5012019-04-01KRISTOFER CARLSON2020-12-01

Plan Statistics for CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN

401k plan membership statisitcs for CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN

Measure Date Value
2022: CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01203
Total number of active participants reported on line 7a of the Form 55002022-04-01173
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01173
Number of employers contributing to the scheme2022-04-010
2021: CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01186
Total number of active participants reported on line 7a of the Form 55002021-04-01203
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01203
Number of employers contributing to the scheme2021-04-010
2020: CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01142
Total number of active participants reported on line 7a of the Form 55002020-04-01186
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01186
Number of employers contributing to the scheme2020-04-010
2019: CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01112
Total number of active participants reported on line 7a of the Form 55002019-04-01142
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01142
Number of employers contributing to the scheme2019-04-010

Form 5500 Responses for CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN

2022: CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: CARLSON ENVIRONMENTAL CONSULTANTS LIFE, ADD, DENTAL AND VISION PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01First time form 5500 has been submittedYes
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0C3JD
Policy instance 1
Insurance contract or identification numberGLUG0C3JD
Number of Individuals Covered175
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $14,985
Total amount of fees paid to insurance companyUSD $5,415
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $117,396
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,985
Amount paid for insurance broker fees2580
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number525628
Policy instance 1
Insurance contract or identification number525628
Number of Individuals Covered204
Insurance policy start date2021-04-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $4,135
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $48,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,135
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number27051
Policy instance 2
Insurance contract or identification number27051
Number of Individuals Covered203
Insurance policy start date2021-11-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $4,583
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,583
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number525628
Policy instance 1
Insurance contract or identification number525628
Number of Individuals Covered186
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $14,628
Total amount of fees paid to insurance companyUSD $924
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $156,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,628
Amount paid for insurance broker fees924
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number525628
Policy instance 1
Insurance contract or identification number525628
Number of Individuals Covered136
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $5,650
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $92,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,934
Amount paid for insurance broker fees0
Insurance broker organization code?3

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