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DLC EMPIRE, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameDLC EMPIRE, LLC WELFARE BENEFIT PLAN
Plan identification number 501

DLC EMPIRE, LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

DLC EMPIRE, LLC has sponsored the creation of one or more 401k plans.

Company Name:DLC EMPIRE, LLC
Employer identification number (EIN):263923952
NAIC Classification:522300
NAIC Description: Activities Related to Credit Intermediation

Additional information about DLC EMPIRE, LLC

Jurisdiction of Incorporation: South Dakota Secretary of State
Incorporation Date:
Company Identification Number: DL017944

More information about DLC EMPIRE, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DLC EMPIRE, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-03-01ALEXIS CRAWFORD2023-10-03
5012021-03-01KRISTI CARNICLE2022-09-29
5012020-03-01KRISTI CARNICLE2021-09-30
5012019-03-01KRISTI CARNICLE2020-05-14
5012018-03-01KRISTI CARNICLE2020-04-10
5012017-03-01KRISTI CARNICLE2020-04-10
5012016-03-01
5012015-03-01JASON MELVIN
5012014-03-01
5012013-03-01CAROL JENT
5012012-03-01CAROL JENT

Plan Statistics for DLC EMPIRE, LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for DLC EMPIRE, LLC WELFARE BENEFIT PLAN

Measure Date Value
2022: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-03-01150
Total number of active participants reported on line 7a of the Form 55002022-03-01187
Number of retired or separated participants receiving benefits2022-03-012
Number of other retired or separated participants entitled to future benefits2022-03-010
Total of all active and inactive participants2022-03-01189
Number of employers contributing to the scheme2022-03-010
2021: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-03-01201
Total number of active participants reported on line 7a of the Form 55002021-03-01149
Number of retired or separated participants receiving benefits2021-03-012
Number of other retired or separated participants entitled to future benefits2021-03-0110
Total of all active and inactive participants2021-03-01161
Number of employers contributing to the scheme2021-03-010
2020: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-03-01285
Total number of active participants reported on line 7a of the Form 55002020-03-01201
Number of retired or separated participants receiving benefits2020-03-014
Number of other retired or separated participants entitled to future benefits2020-03-018
Total of all active and inactive participants2020-03-01213
Number of employers contributing to the scheme2020-03-010
2019: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-03-01267
Total number of active participants reported on line 7a of the Form 55002019-03-01284
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-01284
Number of employers contributing to the scheme2019-03-010
2018: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-03-01262
Total number of active participants reported on line 7a of the Form 55002018-03-01211
Number of retired or separated participants receiving benefits2018-03-010
Number of other retired or separated participants entitled to future benefits2018-03-010
Total of all active and inactive participants2018-03-01211
Number of employers contributing to the scheme2018-03-010
2017: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-03-01322
Total number of active participants reported on line 7a of the Form 55002017-03-01269
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-01269
Number of employers contributing to the scheme2017-03-010
2016: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-03-01385
Total number of active participants reported on line 7a of the Form 55002016-03-01322
Number of retired or separated participants receiving benefits2016-03-010
Number of other retired or separated participants entitled to future benefits2016-03-010
Total of all active and inactive participants2016-03-01322
2015: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-03-01385
Total number of active participants reported on line 7a of the Form 55002015-03-01385
Number of retired or separated participants receiving benefits2015-03-010
Number of other retired or separated participants entitled to future benefits2015-03-010
Total of all active and inactive participants2015-03-01385
2014: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-03-01378
Total number of active participants reported on line 7a of the Form 55002014-03-01385
Number of retired or separated participants receiving benefits2014-03-010
Number of other retired or separated participants entitled to future benefits2014-03-010
Total of all active and inactive participants2014-03-01385
2013: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-03-01328
Total number of active participants reported on line 7a of the Form 55002013-03-01375
Number of retired or separated participants receiving benefits2013-03-013
Number of other retired or separated participants entitled to future benefits2013-03-010
Total of all active and inactive participants2013-03-01378
2012: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-03-01231
Total number of active participants reported on line 7a of the Form 55002012-03-01224
Number of retired or separated participants receiving benefits2012-03-010
Number of other retired or separated participants entitled to future benefits2012-03-010
Total of all active and inactive participants2012-03-01224

Form 5500 Responses for DLC EMPIRE, LLC WELFARE BENEFIT PLAN

2022: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes
2016: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01Submission has been amendedNo
2016-03-01This submission is the final filingNo
2016-03-01This return/report is a short plan year return/report (less than 12 months)No
2016-03-01Plan is a collectively bargained planNo
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan benefit arrangement – InsuranceYes
2015: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-03-01Type of plan entitySingle employer plan
2015-03-01Submission has been amendedNo
2015-03-01This submission is the final filingNo
2015-03-01This return/report is a short plan year return/report (less than 12 months)No
2015-03-01Plan is a collectively bargained planNo
2015-03-01Plan funding arrangement – InsuranceYes
2015-03-01Plan benefit arrangement – InsuranceYes
2014: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-03-01Type of plan entitySingle employer plan
2014-03-01Submission has been amendedNo
2014-03-01This submission is the final filingNo
2014-03-01This return/report is a short plan year return/report (less than 12 months)No
2014-03-01Plan is a collectively bargained planNo
2014-03-01Plan funding arrangement – InsuranceYes
2014-03-01Plan benefit arrangement – InsuranceYes
2013: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-03-01Type of plan entitySingle employer plan
2013-03-01Submission has been amendedNo
2013-03-01This submission is the final filingNo
2013-03-01This return/report is a short plan year return/report (less than 12 months)No
2013-03-01Plan is a collectively bargained planNo
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: DLC EMPIRE, LLC WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Submission has been amendedNo
2012-03-01This submission is the final filingNo
2012-03-01This return/report is a short plan year return/report (less than 12 months)No
2012-03-01Plan is a collectively bargained planNo
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1138609
Policy instance 2
Insurance contract or identification number1138609
Number of Individuals Covered248
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $6,132
Total amount of fees paid to insurance companyUSD $5,614
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $81,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,132
Amount paid for insurance broker fees4343
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number60001291
Policy instance 1
Insurance contract or identification number60001291
Number of Individuals Covered100
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $18,182
Total amount of fees paid to insurance companyUSD $1,652
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $568,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $18,182
Amount paid for insurance broker fees1652
Additional information about fees paid to insurance brokerOVERRIDE COMPENSATION
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1138609
Policy instance 2
Insurance contract or identification number1138609
Number of Individuals Covered220
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $6,635
Total amount of fees paid to insurance companyUSD $4,792
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $88,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,635
Amount paid for insurance broker fees4792
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number60001291
Policy instance 1
Insurance contract or identification number60001291
Number of Individuals Covered94
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $2,056,643
Total amount of fees paid to insurance companyUSD $1,441,137
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,085,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,056,643
Amount paid for insurance broker fees1441137
Additional information about fees paid to insurance brokerOVERRIDE COMPENSATION
Insurance broker organization code?3
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number0263
Policy instance 2
Insurance contract or identification number0263
Number of Individuals Covered211
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $10,117
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $106,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,117
Amount paid for insurance broker fees0
Insurance broker organization code?3
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number60001291
Policy instance 1
Insurance contract or identification number60001291
Number of Individuals Covered117
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $17,236
Total amount of fees paid to insurance companyUSD $15,799
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $628,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $17,236
Amount paid for insurance broker fees15799
Additional information about fees paid to insurance brokerOVERRIDE COMPENSATION
Insurance broker organization code?3
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number60001291
Policy instance 1
Insurance contract or identification number60001291
Number of Individuals Covered129
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $19,689
Total amount of fees paid to insurance companyUSD $18,048
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $656,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $19,689
Amount paid for insurance broker fees18048
Additional information about fees paid to insurance brokerOVERRIDE COMPENSATION
Insurance broker organization code?3
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number4720
Policy instance 2
Insurance contract or identification number4720
Number of Individuals Covered222
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $9,239
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $97,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,239
Amount paid for insurance broker fees0
Insurance broker organization code?3
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number4720
Policy instance 3
Insurance contract or identification number4720
Number of Individuals Covered140
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $7,771
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $97,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,771
Amount paid for insurance broker fees0
Insurance broker organization code?3
SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract numberGRP070519
Policy instance 2
Insurance contract or identification numberGRP070519
Number of Individuals Covered211
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $3,311
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $21,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,311
Amount paid for insurance broker fees0
Insurance broker organization code?3
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number60001291
Policy instance 1
Insurance contract or identification number60001291
Number of Individuals Covered139
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $21,552
Total amount of fees paid to insurance companyUSD $19,756
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $655,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $21,552
Amount paid for insurance broker fees19756
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00484692
Policy instance 2
Insurance contract or identification number00484692
Number of Individuals Covered269
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $13,254
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $131,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number60001291
Policy instance 1
Insurance contract or identification number60001291
Number of Individuals Covered162
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $18,069
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $779,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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