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PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN 401k Plan overview

Plan NamePREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN
Plan identification number 501

PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • 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.

401k Sponsoring company profile

PREMIER AUTOMATION has sponsored the creation of one or more 401k plans.

Company Name:PREMIER AUTOMATION
Employer identification number (EIN):204309879
NAIC Classification:335310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-08-01
5012017-08-01WALTER J. DOLLARD2019-04-30
5012013-08-01VINCE CANNELLA

Plan Statistics for PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN

401k plan membership statisitcs for PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN

Measure Date Value
2018: PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01118
Total number of active participants reported on line 7a of the Form 55002018-08-010
Number of retired or separated participants receiving benefits2018-08-010
Number of other retired or separated participants entitled to future benefits2018-08-010
Total of all active and inactive participants2018-08-010
2017: PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01118
Total number of active participants reported on line 7a of the Form 55002017-08-01118
Number of retired or separated participants receiving benefits2017-08-010
Number of other retired or separated participants entitled to future benefits2017-08-010
Total of all active and inactive participants2017-08-01118
2013: PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01100
Total number of active participants reported on line 7a of the Form 55002013-08-0194
Number of retired or separated participants receiving benefits2013-08-010
Number of other retired or separated participants entitled to future benefits2013-08-010
Total of all active and inactive participants2013-08-0194
Total participants2013-08-0194

Form 5500 Responses for PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN

2018: PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01This submission is the final filingYes
2018-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – InsuranceYes
2017: PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2013: PREMIER AUTOMATION HOLDINGS, INC. LIFE LTD & STD PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01First time form 5500 has been submittedYes
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 157928
Policy instance 1
Insurance contract or identification numberGL 157928
Number of Individuals Covered120
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $3,337
Total amount of fees paid to insurance companyUSD $94
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $22,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 165686
Policy instance 2
Insurance contract or identification numberG 165686
Number of Individuals Covered118
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $3,018
Total amount of fees paid to insurance companyUSD $81
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 207557
Policy instance 3
Insurance contract or identification numberVAR 207557
Number of Individuals Covered119
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $284
Total amount of fees paid to insurance companyUSD $8
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 128978
Policy instance 4
Insurance contract or identification numberLTD 128978
Number of Individuals Covered93
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $2,569
Total amount of fees paid to insurance companyUSD $52
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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