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KIA GEORGIA, INC. EMPLOYEE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameKIA GEORGIA, INC. EMPLOYEE WELFARE BENEFIT PLAN
Plan identification number 501

KIA GEORGIA, INC. EMPLOYEE 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

KIA GEORGIA, INC. has sponsored the creation of one or more 401k plans.

Company Name:KIA GEORGIA, INC.
Employer identification number (EIN):205762938
NAIC Classification:336100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KIA GEORGIA, INC. EMPLOYEE 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

Plan Statistics for KIA GEORGIA, INC. EMPLOYEE WELFARE BENEFIT PLAN

401k plan membership statisitcs for KIA GEORGIA, INC. EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2022: KIA GEORGIA, INC. EMPLOYEE WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-012,534
Total number of active participants reported on line 7a of the Form 55002022-01-012,688
Total of all active and inactive participants2022-01-012,688
Total participants2022-01-012,688
2021: KIA GEORGIA, INC. EMPLOYEE WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-012,477
Total number of active participants reported on line 7a of the Form 55002021-01-012,534
Total of all active and inactive participants2021-01-012,534
Total participants2021-01-012,534

Form 5500 Responses for KIA GEORGIA, INC. EMPLOYEE WELFARE BENEFIT PLAN

2022: KIA GEORGIA, INC. EMPLOYEE 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: KIA GEORGIA, INC. EMPLOYEE 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

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8374
Policy instance 1
Insurance contract or identification numberGA8374
Number of Individuals Covered6090
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $65,933
Total amount of fees paid to insurance companyUSD $101,039
Health Insurance Welfare BenefitYes
Other welfare benefits providedCOBRA SERVICES
Welfare Benefit Premiums Paid to CarrierUSD $5,249,970
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,933
Amount paid for insurance broker fees101039
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, BONUS
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract numberGA8374
Policy instance 2
Insurance contract or identification numberGA8374
Number of Individuals Covered6170
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $30,430
Total amount of fees paid to insurance companyUSD $46,632
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,423,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,430
Amount paid for insurance broker fees46632
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATIONS AND TRAINING
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number942558
Policy instance 3
Insurance contract or identification number942558
Number of Individuals Covered2795
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $26,106
Total amount of fees paid to insurance companyUSD $15,000
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $2,389,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,106
Amount paid for insurance broker fees15000
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATIONS AND TRAINING
Insurance broker organization code?3
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA1986
Policy instance 1
Insurance contract or identification numberGA1986
Insurance policy start date2021-01-01
Insurance policy end date2021-03-31
Total amount of fees paid to insurance companyUSD $992
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 $546,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees992
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATIONS AND TRAINING
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8374
Policy instance 2
Insurance contract or identification numberGA8374
Number of Individuals Covered5916
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $64,222
Total amount of fees paid to insurance companyUSD $20,458
Health Insurance Welfare BenefitYes
Other welfare benefits providedCOBRA SERVICES
Welfare Benefit Premiums Paid to CarrierUSD $5,074,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64,222
Amount paid for insurance broker fees20458
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATIONS AND TRAINING
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract numberGA8374
Policy instance 3
Insurance contract or identification numberGA8374
Number of Individuals Covered5985
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $29,678
Total amount of fees paid to insurance companyUSD $9,454
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,344,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,678
Amount paid for insurance broker fees9454
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATIONS AND TRAINING
Insurance broker organization code?4
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number942558
Policy instance 4
Insurance contract or identification number942558
Number of Individuals Covered2534
Insurance policy start date2021-03-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $21,550
Total amount of fees paid to insurance companyUSD $6,806
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $1,898,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,571
Insurance broker organization code?3
Amount paid for insurance broker fees6806
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, BONUS

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