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NYDJ MEDICAL PLAN 401k Plan overview

Plan NameNYDJ MEDICAL PLAN
Plan identification number 501

NYDJ MEDICAL PLAN Benefits

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

401k Sponsoring company profile

NYDJ APPAREL, LLC has sponsored the creation of one or more 401k plans.

Company Name:NYDJ APPAREL, LLC
Employer identification number (EIN):263203011
NAIC Classification:315280
NAIC Description:Other Cut and Sew Apparel Manufacturing

Additional information about NYDJ APPAREL, LLC

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 2008-08-04
Company Identification Number: 3704440
Legal Registered Office Address: 28 LIBERTY ST.
New York
NEW YORK
United States of America (USA)
10005

More information about NYDJ APPAREL, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NYDJ MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-09-01
5012019-09-01
5012018-09-01
5012017-09-01
5012016-09-01SHANNON HILL
5012015-09-01JASON FRAME
5012014-09-01ERIC UENO
5012013-09-01STEVE BRINK

Plan Statistics for NYDJ MEDICAL PLAN

401k plan membership statisitcs for NYDJ MEDICAL PLAN

Measure Date Value
2019: NYDJ MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01189
Total number of active participants reported on line 7a of the Form 55002019-09-01127
Number of retired or separated participants receiving benefits2019-09-014
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-01131
Total participants2019-09-010
2018: NYDJ MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01155
Total number of active participants reported on line 7a of the Form 55002018-09-01186
Number of retired or separated participants receiving benefits2018-09-013
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01189
2017: NYDJ MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01253
Total number of active participants reported on line 7a of the Form 55002017-09-01155
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01155
2016: NYDJ MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01273
Total number of active participants reported on line 7a of the Form 55002016-09-01253
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01253
2015: NYDJ MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01156
Total number of active participants reported on line 7a of the Form 55002015-09-01273
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-01273
2014: NYDJ MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01153
Total number of active participants reported on line 7a of the Form 55002014-09-01156
Number of retired or separated participants receiving benefits2014-09-010
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-01156
2013: NYDJ MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01107
Total number of active participants reported on line 7a of the Form 55002013-09-01153
Total of all active and inactive participants2013-09-01153

Form 5500 Responses for NYDJ MEDICAL PLAN

2019: NYDJ MEDICAL PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – General assets of the sponsorYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: NYDJ MEDICAL PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – General assets of the sponsorYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: NYDJ MEDICAL PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)No
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – General assets of the sponsorYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: NYDJ MEDICAL PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: NYDJ MEDICAL PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: NYDJ MEDICAL PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: NYDJ MEDICAL PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01First time form 5500 has been submittedYes
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number281340
Policy instance 1
Insurance contract or identification number281340
Number of Individuals Covered102
Insurance policy start date2019-09-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $39,331
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $784,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,752
Insurance broker organization code?3
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number281340
Policy instance 1
Insurance contract or identification number281340
Number of Individuals Covered142
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $80,585
Total amount of fees paid to insurance companyUSD $5,058
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,622,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,721
Amount paid for insurance broker fees2687
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number281340
Policy instance 1
Insurance contract or identification number281340
Number of Individuals Covered155
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $77,543
Total amount of fees paid to insurance companyUSD $7,041
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,710,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number905803
Policy instance 1
Insurance contract or identification number905803
Number of Individuals Covered273
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $92,386
Total amount of fees paid to insurance companyUSD $7,861
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,847,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $92,386
Insurance broker organization code?3
Amount paid for insurance broker fees7861
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameLOCKTON COMPANIES, LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number495391
Policy instance 2
Insurance contract or identification number495391
Number of Individuals Covered82
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $40,870
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $817,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,870
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number352225
Policy instance 1
Insurance contract or identification number352225
Number of Individuals Covered74
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $39,791
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $795,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,791
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number495391
Policy instance 1
Insurance contract or identification number495391
Number of Individuals Covered82
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $38,785
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $775,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,658
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number352224
Policy instance 2
Insurance contract or identification number352224
Number of Individuals Covered71
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $22,679
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $676,956
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,571
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC

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