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CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameCARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN
Plan identification number 501

CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CARNEGIE ROBOTICS, LLC has sponsored the creation of one or more 401k plans.

Company Name:CARNEGIE ROBOTICS, LLC
Employer identification number (EIN):300630355
NAIC Classification:334500

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-12-01BRENDAN SULLIVAN2023-08-02
5012020-12-01JORDAN HAWKER2022-03-28
5012019-12-01JORDAN HAWKER2021-09-09

Plan Statistics for CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN

401k plan membership statisitcs for CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN

Measure Date Value
2021: CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-01117
Total number of active participants reported on line 7a of the Form 55002021-12-01121
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-01121
Number of employers contributing to the scheme2021-12-010
2020: CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01114
Total number of active participants reported on line 7a of the Form 55002020-12-01109
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-01109
Number of employers contributing to the scheme2020-12-010
2019: CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01107
Total number of active participants reported on line 7a of the Form 55002019-12-01117
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01117
Number of employers contributing to the scheme2019-12-010

Form 5500 Responses for CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN

2021: CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – InsuranceYes
2020: CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: CARNEGIE ROBOTICS, LLC HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01First time form 5500 has been submittedYes
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number70971
Policy instance 1
Insurance contract or identification number70971
Number of Individuals Covered121
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $12,988
Total amount of fees paid to insurance companyUSD $18
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 $74,644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,047
Insurance broker organization code?3
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION FEES
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number272188
Policy instance 2
Insurance contract or identification number272188
Number of Individuals Covered188
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $5,605
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,605
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 number522350
Policy instance 1
Insurance contract or identification number522350
Number of Individuals Covered109
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $16,866
Total amount of fees paid to insurance companyUSD $0
Dental 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 $103,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,666
Insurance broker organization code?3
Amount paid for insurance broker fees0
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number522350
Policy instance 1
Insurance contract or identification number522350
Number of Individuals Covered117
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $17,910
Total amount of fees paid to insurance companyUSD $0
Dental 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 $128,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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