REVSTONE INDUSTRIES has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan REVSTONE INDUSTRIES, LLC, GROUP HEALTH PLAN
| Measure | Date | Value |
|---|
| 2017: REVSTONE INDUSTRIES, LLC, GROUP HEALTH PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 172 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 0 |
| Number of employers contributing to the scheme | 2017-01-01 | 0 |
| 2016: REVSTONE INDUSTRIES, LLC, GROUP HEALTH PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 199 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 172 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 172 |
| 2015: REVSTONE INDUSTRIES, LLC, GROUP HEALTH PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 212 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 199 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 199 |
| 2014: REVSTONE INDUSTRIES, LLC, GROUP HEALTH PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 202 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 213 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 213 |
| 2017: REVSTONE INDUSTRIES, LLC, GROUP HEALTH PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | This submission is the final filing | Yes |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: REVSTONE INDUSTRIES, LLC, GROUP HEALTH PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: REVSTONE INDUSTRIES, LLC, GROUP HEALTH PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: REVSTONE INDUSTRIES, LLC, GROUP HEALTH PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | First time form 5500 has been submitted | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 00059726 |
| Policy instance | 1 |
| Insurance contract or identification number | 00059726 | | Number of Individuals Covered | 191 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-06-30 | | Total amount of commissions paid to insurance broker | USD $25,816 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,089,173 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,816 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKTON COMPANIES, LLC |
|
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
| Policy contract number | 00240962 |
| Policy instance | 1 |
| Insurance contract or identification number | 00240962 | | Number of Individuals Covered | 502 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $50,500 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,184,095 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,420 | | Insurance broker organization code? | 3 | | Insurance broker name | KEYSTONE INSURANCE & BENEFITS GROUP |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000010729 |
| Policy instance | 2 |
| Insurance contract or identification number | 0000010729 | | Number of Individuals Covered | 420 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,163 | | Other welfare benefits provided | ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $15,396 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $302 | | Insurance broker organization code? | 3 | | Insurance broker name | JEFFREY C WERNER |
|
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
| Policy contract number | 00240962 |
| Policy instance | 1 |
| Insurance contract or identification number | 00240962 | | Number of Individuals Covered | 524 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $48,580 | | Total amount of fees paid to insurance company | USD $8,000 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,212,838 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,760 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 8000 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker name | AL TORSTICK INSURANCE AGENCY INC |
|
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