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MALLORY SAFETY AND SUPPLY MEDICAL 401k Plan overview

Plan NameMALLORY SAFETY AND SUPPLY MEDICAL
Plan identification number 501

MALLORY SAFETY AND SUPPLY MEDICAL Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

MALLORY SAFETY AND SUPPLY LLC has sponsored the creation of one or more 401k plans.

Company Name:MALLORY SAFETY AND SUPPLY LLC
Employer identification number (EIN):273905150
NAIC Classification:423990
NAIC Description:Other Miscellaneous Durable Goods Merchant Wholesalers

Additional information about MALLORY SAFETY AND SUPPLY LLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 2010-11-04
Company Identification Number: 603061535
Legal Registered Office Address: 1040 INDUSTRIAL WAY

LONGVIEW
United States of America (USA)
986320000

More information about MALLORY SAFETY AND SUPPLY LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MALLORY SAFETY AND SUPPLY MEDICAL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-07-01HALEY ROTT2022-10-18
5012021-07-01HALEY ROTT2023-12-19
5012020-07-01ABIGAIL DILLAVOU2022-03-09

Plan Statistics for MALLORY SAFETY AND SUPPLY MEDICAL

401k plan membership statisitcs for MALLORY SAFETY AND SUPPLY MEDICAL

Measure Date Value
2021: MALLORY SAFETY AND SUPPLY MEDICAL 2021 401k membership
Total participants, beginning-of-year2021-07-01205
Total number of active participants reported on line 7a of the Form 55002021-07-01212
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01212
Number of employers contributing to the scheme2021-07-010
2020: MALLORY SAFETY AND SUPPLY MEDICAL 2020 401k membership
Total participants, beginning-of-year2020-07-01100
Total number of active participants reported on line 7a of the Form 55002020-07-01205
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01205
Number of employers contributing to the scheme2020-07-010

Form 5500 Responses for MALLORY SAFETY AND SUPPLY MEDICAL

2021: MALLORY SAFETY AND SUPPLY MEDICAL 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedYes
2021-07-01This submission is the final filingYes
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: MALLORY SAFETY AND SUPPLY MEDICAL 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01First time form 5500 has been submittedYes
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 )
Policy contract number10003886
Policy instance 1
Insurance contract or identification number10003886
Number of Individuals Covered325
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $9,251
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,018,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees9251
Additional information about fees paid to insurance brokerBONUS, NON-MONETARY COMPENSATION
Insurance broker organization code?3
REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 )
Policy contract number10003886
Policy instance 1
Insurance contract or identification number10003886
Number of Individuals Covered344
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $76
Total amount of fees paid to insurance companyUSD $4,020
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,695,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $76
Amount paid for insurance broker fees4020
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3

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