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RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 401k Plan overview

Plan NameRASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN
Plan identification number 501

RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

RASA FLOORS & CARPET CLEANING, LLC has sponsored the creation of one or more 401k plans.

Company Name:RASA FLOORS & CARPET CLEANING, LLC
Employer identification number (EIN):271519180
NAIC Classification:442210
NAIC Description:Floor Covering Stores

Additional information about RASA FLOORS & CARPET CLEANING, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2002-05-31
Company Identification Number: 0800090010
Legal Registered Office Address: PO BOX 110067

CARROLLTON
United States of America (USA)
75011

More information about RASA FLOORS & CARPET CLEANING, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01KEITH OLINGER2023-07-10
5012021-01-01KEITH OLINGER2022-03-16
5012020-01-01KEITH OLINGER2021-03-10
5012019-01-01KEITH OLINGER2020-05-07
5012017-01-01
5012014-01-01CRAIG SUTTON

Plan Statistics for RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN

401k plan membership statisitcs for RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN

Measure Date Value
2022: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0190
Total number of active participants reported on line 7a of the Form 55002022-01-0191
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0191
Number of employers contributing to the scheme2022-01-010
2021: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01105
Total number of active participants reported on line 7a of the Form 55002021-01-01109
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01109
Number of employers contributing to the scheme2021-01-010
2020: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01105
Total number of active participants reported on line 7a of the Form 55002020-01-01104
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-016
Total of all active and inactive participants2020-01-01110
Number of employers contributing to the scheme2020-01-010
2019: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01104
Total number of active participants reported on line 7a of the Form 55002019-01-01116
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01116
Number of employers contributing to the scheme2019-01-010
2017: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01101
Total number of active participants reported on line 7a of the Form 55002017-01-0197
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0197
2014: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01158
Total number of active participants reported on line 7a of the Form 55002014-01-01158
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01158

Form 5500 Responses for RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN

2022: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: RASA FLOORS AND CARPET CLEANING LLC HEALTH & WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number280135
Policy instance 2
Insurance contract or identification number280135
Number of Individuals Covered224
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $39,976
Total amount of fees paid to insurance companyUSD $2,574
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $924,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $30,199
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS, NON-MONETARY COMPENSATION
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF025159
Policy instance 1
Insurance contract or identification numberF025159
Number of Individuals Covered109
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $16,298
Total amount of fees paid to insurance companyUSD $3,031
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $114,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,342
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number280135
Policy instance 2
Insurance contract or identification number280135
Number of Individuals Covered211
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $39,377
Total amount of fees paid to insurance companyUSD $6,965
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $840,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $39,377
Amount paid for insurance broker fees6965
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF025159
Policy instance 1
Insurance contract or identification numberF025159
Number of Individuals Covered104
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $12,897
Total amount of fees paid to insurance companyUSD $4,351
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $90,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,897
Amount paid for insurance broker fees4351
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number280135
Policy instance 2
Insurance contract or identification number280135
Number of Individuals Covered192
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $39,989
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $879,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $39,989
Amount paid for insurance broker fees0
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF025159
Policy instance 1
Insurance contract or identification numberF025159
Number of Individuals Covered100
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $13,338
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $93,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,338
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number913880
Policy instance 2
Insurance contract or identification number913880
Number of Individuals Covered226
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $7,392
Total amount of fees paid to insurance companyUSD $40,303
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $840,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,392
Amount paid for insurance broker fees40303
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number526108
Policy instance 1
Insurance contract or identification number526108
Number of Individuals Covered116
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $10,365
Total amount of fees paid to insurance companyUSD $73
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $69,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,365
Amount paid for insurance broker fees73
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number526108
Policy instance 2
Insurance contract or identification number526108
Number of Individuals Covered129
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $16,387
Total amount of fees paid to insurance companyUSD $234
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $119,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,387
Amount paid for insurance broker fees234
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameFROST INSURANCE AGENCY, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number79922
Policy instance 1
Insurance contract or identification number79922
Number of Individuals Covered94
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $28,496
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $570,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $28,496
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameFROST INSURANCE AGENCY, INC.

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