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DIVERSIFIED AUTOMATION BENEFITS PLAN 401k Plan overview

Plan NameDIVERSIFIED AUTOMATION BENEFITS PLAN
Plan identification number 501

DIVERSIFIED AUTOMATION BENEFITS 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

DIVERSIFIED AUTOMATION, INC. has sponsored the creation of one or more 401k plans.

Company Name:DIVERSIFIED AUTOMATION, INC.
Employer identification number (EIN):300196705
NAIC Classification:541330
NAIC Description:Engineering Services

Additional information about DIVERSIFIED AUTOMATION, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2005-08-12
Company Identification Number: 0800530880
Legal Registered Office Address: 1914 STANLEY GAULT PKWY

LOUISVILLE
United States of America (USA)
40223

More information about DIVERSIFIED AUTOMATION, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DIVERSIFIED AUTOMATION BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01MICHELLE HIKES2023-05-08
5012021-01-01MICHELLE HIKES2022-04-26
5012020-01-01MICHELLE HIKES2021-07-29
5012019-01-01MICHELLE HIKES2020-06-30
5012018-01-01MICHELLE HIKES2019-08-15

Plan Statistics for DIVERSIFIED AUTOMATION BENEFITS PLAN

401k plan membership statisitcs for DIVERSIFIED AUTOMATION BENEFITS PLAN

Measure Date Value
2022: DIVERSIFIED AUTOMATION BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01152
Total number of active participants reported on line 7a of the Form 55002022-01-01159
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 participants2022-01-01159
Number of employers contributing to the scheme2022-01-010
2021: DIVERSIFIED AUTOMATION BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01150
Total number of active participants reported on line 7a of the Form 55002021-01-01152
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 participants2021-01-01152
Number of employers contributing to the scheme2021-01-010
2020: DIVERSIFIED AUTOMATION BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01168
Total number of active participants reported on line 7a of the Form 55002020-01-01143
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01143
Number of employers contributing to the scheme2020-01-010
2019: DIVERSIFIED AUTOMATION BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01158
Total number of active participants reported on line 7a of the Form 55002019-01-01168
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 participants2019-01-01168
Number of employers contributing to the scheme2019-01-010
2018: DIVERSIFIED AUTOMATION BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01100
Total number of active participants reported on line 7a of the Form 55002018-01-01158
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01158
Number of employers contributing to the scheme2018-01-010

Form 5500 Responses for DIVERSIFIED AUTOMATION BENEFITS PLAN

2022: DIVERSIFIED AUTOMATION BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: DIVERSIFIED AUTOMATION BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: DIVERSIFIED AUTOMATION BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: DIVERSIFIED AUTOMATION BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: DIVERSIFIED AUTOMATION BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract number0713220
Policy instance 3
Insurance contract or identification number0713220
Number of Individuals Covered215
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $6,823
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 $6,823
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberKY2374
Policy instance 2
Insurance contract or identification numberKY2374
Number of Individuals Covered159
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,176
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
Welfare Benefit Premiums Paid to CarrierUSD $270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,176
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract numberKY2374
Policy instance 1
Insurance contract or identification numberKY2374
Number of Individuals Covered218
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $35,254
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,222,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,230
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberKY2374
Policy instance 2
Insurance contract or identification numberKY2374
Number of Individuals Covered160
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $13,417
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
Welfare Benefit Premiums Paid to CarrierUSD $86,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,388
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract numberKY2374
Policy instance 1
Insurance contract or identification numberKY2374
Number of Individuals Covered296
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $38,275
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 $1,218,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,525
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberKY2374
Policy instance 2
Insurance contract or identification numberKY2374
Number of Individuals Covered143
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $10,757
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
Welfare Benefit Premiums Paid to CarrierUSD $88,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,757
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract numberKY2374
Policy instance 1
Insurance contract or identification numberKY2374
Number of Individuals Covered223
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $34,778
Total amount of fees paid to insurance companyUSD $4,352
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,208,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,336
Amount paid for insurance broker fees4352
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 )
Policy contract number796347
Policy instance 3
Insurance contract or identification number796347
Number of Individuals Covered168
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,629
Total amount of fees paid to insurance companyUSD $2,476
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,629
Amount paid for insurance broker fees2476
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number447210
Policy instance 2
Insurance contract or identification number447210
Number of Individuals Covered168
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $8,401
Total amount of fees paid to insurance companyUSD $3,180
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $72,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,401
Amount paid for insurance broker fees3180
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number796347
Policy instance 1
Insurance contract or identification number796347
Number of Individuals Covered165
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $33,516
Total amount of fees paid to insurance companyUSD $12,407
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,183,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,516
Amount paid for insurance broker fees12407
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 )
Policy contract number796347
Policy instance 3
Insurance contract or identification number796347
Number of Individuals Covered157
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,185
Total amount of fees paid to insurance companyUSD $3,972
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,072
Amount paid for insurance broker fees2000
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number447210
Policy instance 2
Insurance contract or identification number447210
Number of Individuals Covered158
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,473
Total amount of fees paid to insurance companyUSD $529
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 $55,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,473
Amount paid for insurance broker fees529
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number796347
Policy instance 1
Insurance contract or identification number796347
Number of Individuals Covered157
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $28,215
Total amount of fees paid to insurance companyUSD $4,643
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $769,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,395
Amount paid for insurance broker fees4643
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3

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