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CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 401k Plan overview

Plan NameCUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN
Plan identification number 501

CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

CUSTOM COOLER INC. has sponsored the creation of one or more 401k plans.

Company Name:CUSTOM COOLER INC.
Employer identification number (EIN):204388288
NAIC Classification:333310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-08-01STEVE LEE STEVE LEE2019-02-04
5012016-08-01STEVE LEE STEVE LEE2017-12-06
5012015-08-01STEVE LEE STEVE LEE2017-02-25

Plan Statistics for CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN

401k plan membership statisitcs for CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN

Measure Date Value
2017: CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01122
Total number of active participants reported on line 7a of the Form 55002017-08-01128
Total of all active and inactive participants2017-08-01128
2016: CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01121
Total number of active participants reported on line 7a of the Form 55002016-08-01122
Total of all active and inactive participants2016-08-01122
2015: CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01115
Total number of active participants reported on line 7a of the Form 55002015-08-01121
Number of retired or separated participants receiving benefits2015-08-010
Number of other retired or separated participants entitled to future benefits2015-08-010
Total of all active and inactive participants2015-08-01121

Form 5500 Responses for CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN

2017: CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan funding arrangement – General assets of the sponsorYes
2017-08-01Plan benefit arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – General assets of the sponsorYes
2016: CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – General assets of the sponsorYes
2016-08-01Plan benefit arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – General assets of the sponsorYes
2015: CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01First time form 5500 has been submittedYes
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – General assets of the sponsorYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract numberS4361A
Policy instance 1
Insurance contract or identification numberS4361A
Number of Individuals Covered128
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $31,626
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $727,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract numberS4361A
Policy instance 1
Insurance contract or identification numberS4361A
Number of Individuals Covered121
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $23,626
Total amount of fees paid to insurance companyUSD $4,200
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $499,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,626
Amount paid for insurance broker fees4200
Additional information about fees paid to insurance brokerEDUCATION, COMMUNICATION AND TRAINING
Insurance broker organization code?3
Insurance broker nameSTEVEN MICHAEL COSLEY

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