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SHINE HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameSHINE HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 502

SHINE HEALTH AND WELFARE BENEFIT 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)

401k Sponsoring company profile

SHINE TECHNOLOGIES, LLC has sponsored the creation of one or more 401k plans.

Company Name:SHINE TECHNOLOGIES, LLC
Employer identification number (EIN):272766459
NAIC Classification:331310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHINE HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-03-01SUSAN PRECHEL2024-01-09
5022022-03-01SUSAN PRECHEL2023-10-03
5022021-03-01DAVID BAILEY2022-12-07
5022020-03-01DAVID BAILEY2021-09-16

Plan Statistics for SHINE HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for SHINE HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2023: SHINE HEALTH AND WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year2023-03-01342
Total number of active participants reported on line 7a of the Form 55002023-03-01357
Number of retired or separated participants receiving benefits2023-03-010
Number of other retired or separated participants entitled to future benefits2023-03-010
Total of all active and inactive participants2023-03-01357
Number of employers contributing to the scheme2023-03-010
2022: SHINE HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-03-01243
Total number of active participants reported on line 7a of the Form 55002022-03-01342
Number of retired or separated participants receiving benefits2022-03-010
Number of other retired or separated participants entitled to future benefits2022-03-010
Total of all active and inactive participants2022-03-01342
Number of employers contributing to the scheme2022-03-010
2021: SHINE HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-03-01115
Total number of active participants reported on line 7a of the Form 55002021-03-01243
Number of retired or separated participants receiving benefits2021-03-010
Number of other retired or separated participants entitled to future benefits2021-03-010
Total of all active and inactive participants2021-03-01243
Number of employers contributing to the scheme2021-03-010
2020: SHINE HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-03-01115
Total number of active participants reported on line 7a of the Form 55002020-03-01115
Number of retired or separated participants receiving benefits2020-03-010
Number of other retired or separated participants entitled to future benefits2020-03-010
Total of all active and inactive participants2020-03-01115
Number of employers contributing to the scheme2020-03-010

Form 5500 Responses for SHINE HEALTH AND WELFARE BENEFIT PLAN

2023: SHINE HEALTH AND WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-03-01Type of plan entitySingle employer plan
2023-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2023-03-01Plan funding arrangement – InsuranceYes
2023-03-01Plan benefit arrangement – InsuranceYes
2022: SHINE HEALTH AND 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: SHINE HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan funding arrangement – General assets of the sponsorYes
2021-03-01Plan benefit arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – General assets of the sponsorYes
2020: SHINE HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01First time form 5500 has been submittedYes
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ARMADACARE (National Association of Insurance Commissioners NAIC id number: 66281 )
Policy contract numberSA001422
Policy instance 5
Insurance contract or identification numberSA001422
Number of Individuals Covered15
Insurance policy start date2023-03-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $200
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $10,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $200
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number584983
Policy instance 4
Insurance contract or identification number584983
Number of Individuals Covered357
Insurance policy start date2023-03-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number41448
Policy instance 3
Insurance contract or identification number41448
Number of Individuals Covered275
Insurance policy start date2023-03-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $237
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $237
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number6919
Policy instance 2
Insurance contract or identification number6919
Number of Individuals Covered340
Insurance policy start date2023-03-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $1,963
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,963
Amount paid for insurance broker fees0
Insurance broker organization code?3
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number17JEKUA
Policy instance 1
Insurance contract or identification number17JEKUA
Number of Individuals Covered432
Insurance policy start date2023-03-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $2,594
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $218,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,594
Amount paid for insurance broker fees0
Insurance broker organization code?3
ARMADACARE (National Association of Insurance Commissioners NAIC id number: 66281 )
Policy contract numberSA001422
Policy instance 5
Insurance contract or identification numberSA001422
Number of Individuals Covered15
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $2,100
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $10,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,100
Amount paid for insurance broker fees0
Insurance broker organization code?3
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number41448
Policy instance 4
Insurance contract or identification number41448
Number of Individuals Covered277
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $3,007
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,007
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number6919
Policy instance 3
Insurance contract or identification number6919
Number of Individuals Covered342
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $29,887
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,887
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number584983
Policy instance 2
Insurance contract or identification number584983
Number of Individuals Covered360
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $50,933
Total amount of fees paid to insurance companyUSD $0
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 $391,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,056
Amount paid for insurance broker fees0
Insurance broker organization code?3
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number17JEKUA
Policy instance 1
Insurance contract or identification number17JEKUA
Number of Individuals Covered498
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $33,792
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,815,897
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $33,792
Amount paid for insurance broker fees0
Insurance broker organization code?3
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number4144800000
Policy instance 3
Insurance contract or identification number4144800000
Number of Individuals Covered174
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $1,712
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,712
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number691900000
Policy instance 2
Insurance contract or identification number691900000
Number of Individuals Covered214
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $16,179
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,179
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number584983
Policy instance 1
Insurance contract or identification number584983
Number of Individuals Covered243
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $28,271
Total amount of fees paid to insurance companyUSD $0
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 $216,798
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,932
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL150719
Policy instance 1
Insurance contract or identification numberGL150719
Number of Individuals Covered115
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $8,162
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $84,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,162
Amount paid for insurance broker fees0
Insurance broker organization code?3

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