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I2M HEALTH PLAN 401k Plan overview

Plan NameI2M HEALTH PLAN
Plan identification number 501

I2M HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

CRESTWOOOD MEMBRANES, INC T/A I2M has sponsored the creation of one or more 401k plans.

Company Name:CRESTWOOOD MEMBRANES, INC T/A I2M
Employer identification number (EIN):264817013
NAIC Classification:423300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan I2M HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-08-01CHRISTOPHER HACKETT2021-01-27

Plan Statistics for I2M HEALTH PLAN

401k plan membership statisitcs for I2M HEALTH PLAN

Measure Date Value
2019: I2M HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-010
Total number of active participants reported on line 7a of the Form 55002019-08-01122
Total of all active and inactive participants2019-08-01122

Form 5500 Responses for I2M HEALTH PLAN

2019: I2M HEALTH PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01First time form 5500 has been submittedYes
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number
Policy instance 1
Number of Individuals Covered117
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00504546
Policy instance 2
Insurance contract or identification number00504546
Number of Individuals Covered122
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $8,570
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $89,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,525
Insurance broker organization code?3

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