CODY POOLS, INC. DENTAL 401k Plan overview
| Plan Name | CODY POOLS, INC. DENTAL |
| Plan identification number | 502 |
CODY POOLS, INC. DENTAL Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Life insurance
- Dental
- Vision
- Death benefits (include travel accident but not life insurance)
|
401k Sponsoring company profile
CODY POOLS, INC. has sponsored the creation of one or more 401k plans.
Additional information about CODY POOLS, INC.
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2007-04-26 |
| Company Identification Number: | 0800807609 |
| Legal Registered Office Address: |
101 E OLD SETTLERS BLVD STE 200
ROUND ROCK
United States of America (USA)
78664
|
More information about CODY POOLS, INC.
Form 5500 Filing Information
Submission information for form 5500 for 401k plan CODY POOLS, INC. DENTAL
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 502 | 2021-10-01 | AREFA HUSSAIN | 2023-06-26 | | |
| 502 | 2020-10-01 | AREFA HUSSAIN | 2022-08-19 | | |
Plan Statistics for CODY POOLS, INC. DENTAL
401k plan membership statisitcs for CODY POOLS, INC. DENTAL
| Measure | Date | Value |
|---|
| 2021: CODY POOLS, INC. DENTAL 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 401 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 0 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 0 |
| Number of employers contributing to the scheme | 2021-10-01 | 0 |
| 2020: CODY POOLS, INC. DENTAL 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-10-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 401 |
| Number of retired or separated participants receiving benefits | 2020-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-10-01 | 0 |
| Total of all active and inactive participants | 2020-10-01 | 401 |
| Number of employers contributing to the scheme | 2020-10-01 | 0 |
Form 5500 Responses for CODY POOLS, INC. DENTAL
| 2021: CODY POOLS, INC. DENTAL 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | This submission is the final filing | Yes |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: CODY POOLS, INC. DENTAL 2020 form 5500 responses |
|---|
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | VF026799 |
| Policy instance | 1 |
| Insurance contract or identification number | VF026799 | | Number of Individuals Covered | 214 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $7,770 | | Total amount of fees paid to insurance company | USD $2,972 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $59,625 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,911 | | Amount paid for insurance broker fees | 2972 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 247420 |
| Policy instance | 2 |
| Insurance contract or identification number | 247420 | | Number of Individuals Covered | 371 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $58,130 | | Total amount of fees paid to insurance company | USD $999 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,675,498 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $28,651 | | Amount paid for insurance broker fees | 999 | | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05989423 |
| Policy instance | 1 |
| Insurance contract or identification number | KM05989423 | | Number of Individuals Covered | 401 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $6,107 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $92,549 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,107 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
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