401k Plan data: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN plan

KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN
Plan identification number	501

KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

KNIESEL'S COLLISION, INC. has sponsored the creation of one or more 401k plans.

Company Name: KNIESEL'S COLLISION, INC.

Employer identification number (EIN): 208102039

NAIC Classification: 811120
NAIC Description: Automotive Body, Paint, Interior, and Glass Repair

Additional information about KNIESEL'S COLLISION, INC.

Jurisdiction of Incorporation: California Department of State

Incorporation Date: 2003-12-18

Company Identification Number: C2568263

Legal Registered Office Address: 4680 Pacific St

Rocklin
United States of America (USA)
95677

More information about KNIESEL'S COLLISION, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-12-01 CHERYL NAVARRETE 2024-05-06
501 2021-12-01 CHERYL NAVARRETE 2023-05-17
501 2020-12-01 CHERYL NAVARRETE 2022-04-22
501 2019-12-01 CHERYL NAVARRETE 2021-05-19
501 2019-12-01 CHERYL NAVARRETE 2024-05-10
501 2018-12-01 CHERYL NAVARRETE 2020-03-13
501 2017-12-01 CHERYL NAVARRETE 2019-06-04
501 2016-12-01
501 2015-12-01 CHERYL NAVARRETE CHERYL NAVARRETE 2017-04-17
501 2014-12-01 CHERYL NAVARRETE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-12-01	CHERYL NAVARRETE	2024-05-06
501	2021-12-01	CHERYL NAVARRETE	2023-05-17
501	2020-12-01	CHERYL NAVARRETE	2022-04-22
501	2019-12-01	CHERYL NAVARRETE	2021-05-19
501	2019-12-01	CHERYL NAVARRETE	2024-05-10
501	2018-12-01	CHERYL NAVARRETE	2020-03-13
501	2017-12-01	CHERYL NAVARRETE	2019-06-04
501	2016-12-01
501	2015-12-01	CHERYL NAVARRETE		CHERYL NAVARRETE	2017-04-17
501	2014-12-01	CHERYL NAVARRETE

Form 5500 Responses for KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN

2022: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-12-01	Type of plan entity	Single employer plan
2022-12-01	Plan funding arrangement – Insurance	Yes
2022-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-12-01	Plan benefit arrangement – Insurance	Yes
2022-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-12-01	Type of plan entity	Single employer plan
2021-12-01	Plan funding arrangement – Insurance	Yes
2021-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-12-01	Plan benefit arrangement – Insurance	Yes
2021-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-12-01	Type of plan entity	Single employer plan
2020-12-01	Plan funding arrangement – Insurance	Yes
2020-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-12-01	Plan benefit arrangement – Insurance	Yes
2020-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-12-01	Type of plan entity	Single employer plan
2019-12-01	Submission has been amended	Yes
2019-12-01	Plan funding arrangement – Insurance	Yes
2019-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-12-01	Plan benefit arrangement – Insurance	Yes
2019-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-12-01	Type of plan entity	Single employer plan
2018-12-01	Plan funding arrangement – Insurance	Yes
2018-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-12-01	Plan benefit arrangement – Insurance	Yes
2018-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-12-01	Type of plan entity	Single employer plan
2017-12-01	Plan funding arrangement – Insurance	Yes
2017-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-12-01	Plan benefit arrangement – Insurance	Yes
2017-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-12-01	Type of plan entity	Single employer plan
2016-12-01	Plan funding arrangement – Insurance	Yes
2016-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-12-01	Plan benefit arrangement – Insurance	Yes
2016-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-12-01	Type of plan entity	Single employer plan
2015-12-01	Submission has been amended	No
2015-12-01	This submission is the final filing	No
2015-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-12-01	Plan is a collectively bargained plan	No
2015-12-01	Plan funding arrangement – Insurance	Yes
2015-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-12-01	Plan benefit arrangement – Insurance	Yes
2015-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: KNIESEL'S COLLISION CENTERS HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-12-01	Type of plan entity	Single employer plan
2014-12-01	First time form 5500 has been submitted	Yes
2014-12-01	Submission has been amended	No
2014-12-01	This submission is the final filing	No
2014-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-12-01	Plan is a collectively bargained plan	No
2014-12-01	Plan funding arrangement – Insurance	Yes
2014-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0BZP8

Policy instance

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

101955

Policy instance

WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )

Policy contract number

104506

Policy instance

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

649088

Policy instance

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

649088

Policy instance

WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )

Policy contract number

104506

Policy instance

MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 54199 )

Policy contract number

7539

Policy instance

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

101955

Policy instance

MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 54199 )

Policy contract number

7539

Policy instance

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

17578

Policy instance

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

101955

Policy instance

WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )

Policy contract number

104506

Policy instance

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

649088

Policy instance

MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 54199 )

Policy contract number

7539

Policy instance

Insurance contract or identification number	7539
Number of Individuals Covered	190
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $209
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $4,172
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

101955

Policy instance

Insurance contract or identification number	101955
Number of Individuals Covered	261
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $1,730
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Welfare Benefit Premiums Paid to Carrier	USD $17,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

101955

Policy instance

WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )

Policy contract number

104506

Policy instance

Insurance contract or identification number	104506
Number of Individuals Covered	65
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $18,092
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $371,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

649088

Policy instance

Insurance contract or identification number	649088
Number of Individuals Covered	249
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $66,318
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,241,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

649088

Policy instance

WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )

Policy contract number

104506

Policy instance

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

101955

Policy instance

WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )

Policy contract number

104506

Policy instance

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

649088

Policy instance

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

101955

Policy instance

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

101955

Policy instance

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

11899

Policy instance

WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )

Policy contract number

104506

Policy instance

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

649088

Policy instance

WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )

Policy contract number

104506

Policy instance

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

649088

Policy instance

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )

Policy contract number

11899

Policy instance

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Company Name:	KNIESEL'S COLLISION, INC.
Employer identification number (EIN):	208102039
NAIC Classification:	811120
NAIC Description:	Automotive Body, Paint, Interior, and Glass Repair

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:	2003-12-18
Company Identification Number:	C2568263
Legal Registered Office Address:	4680 Pacific St Rocklin United States of America (USA) 95677