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KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN 401k Plan overview

Plan NameKIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN
Plan identification number 501

KIM INTERNATIONAL CORPORATION 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

401k Sponsoring company profile

KIM INTERNATIONAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:KIM INTERNATIONAL CORPORATION
Employer identification number (EIN):274213808
NAIC Classification:423940
NAIC Description:Jewelry, Watch, Precious Stone, and Precious Metal Merchant Wholesalers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-09-01RHIANA BARR2021-06-02
5012019-09-01RHIANA BARR2021-01-27
5012018-09-01CHRIS TEDFORD2020-02-26

Plan Statistics for KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN

401k plan membership statisitcs for KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN

Measure Date Value
2020: KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01125
Total number of active participants reported on line 7a of the Form 55002020-09-01103
Number of retired or separated participants receiving benefits2020-09-018
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01111
Number of employers contributing to the scheme2020-09-010
2019: KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01196
Total number of active participants reported on line 7a of the Form 55002019-09-01121
Number of retired or separated participants receiving benefits2019-09-010
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-01121
Number of employers contributing to the scheme2019-09-010
2018: KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01115
Total number of active participants reported on line 7a of the Form 55002018-09-01236
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01236
Number of employers contributing to the scheme2018-09-010

Form 5500 Responses for KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN

2020: KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: KIM INTERNATIONAL CORPORATION HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01First time form 5500 has been submittedYes
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number149879
Policy instance 1
Insurance contract or identification number149879
Number of Individuals Covered192
Insurance policy start date2020-09-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,617
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $268,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,617
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BL7M
Policy instance 2
Insurance contract or identification numberGLUG0BL7M
Number of Individuals Covered102
Insurance policy start date2020-09-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,084
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,084
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number281922
Policy instance 1
Insurance contract or identification number281922
Number of Individuals Covered153
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $81,219
Total amount of fees paid to insurance companyUSD $5,829
Health Insurance Welfare BenefitYes
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, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,217,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,219
Amount paid for insurance broker fees5829
Insurance broker organization code?3
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number281922
Policy instance 1
Insurance contract or identification number281922
Number of Individuals Covered278
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $60,114
Total amount of fees paid to insurance companyUSD $5,651
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,124,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,114
Amount paid for insurance broker fees5651
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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