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EXCELLENCE LOGGING HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameEXCELLENCE LOGGING HEALTH AND WELFARE PLAN
Plan identification number 501

EXCELLENCE LOGGING HEALTH AND 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
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

EXCELLENCE LOGGING US, INC. has sponsored the creation of one or more 401k plans.

Company Name:EXCELLENCE LOGGING US, INC.
Employer identification number (EIN):300869531
NAIC Classification:213110
NAIC Description: Support Activities for Mining

Additional information about EXCELLENCE LOGGING US, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2015-05-06
Company Identification Number: 0802209986
Legal Registered Office Address: 3433 N SAM HOUSTON PKWY W STE 400

HOUSTON
United States of America (USA)
77086

More information about EXCELLENCE LOGGING US, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EXCELLENCE LOGGING HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-04-01MARGARET STARR2021-10-14

Plan Statistics for EXCELLENCE LOGGING HEALTH AND WELFARE PLAN

401k plan membership statisitcs for EXCELLENCE LOGGING HEALTH AND WELFARE PLAN

Measure Date Value
2020: EXCELLENCE LOGGING HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01173
Total number of active participants reported on line 7a of the Form 55002020-04-0178
Number of retired or separated participants receiving benefits2020-04-0115
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-0193
Number of employers contributing to the scheme2020-04-010

Form 5500 Responses for EXCELLENCE LOGGING HEALTH AND WELFARE PLAN

2020: EXCELLENCE LOGGING HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01First time form 5500 has been submittedYes
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5969185
Policy instance 1
Insurance contract or identification number5969185
Number of Individuals Covered78
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $2,564
Total amount of fees paid to insurance companyUSD $276
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $19,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,564
Amount paid for insurance broker fees274
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION SUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number151856
Policy instance 2
Insurance contract or identification number151856
Number of Individuals Covered130
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $43,026
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $830,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees43026
Additional information about fees paid to insurance broker2020 PINNACLE MEDICAL NEW BUSINESS INCENTIVE RISK DIRECT COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number573015
Policy instance 3
Insurance contract or identification number573015
Number of Individuals Covered71
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $9,722
Total amount of fees paid to insurance companyUSD $5,165
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $85,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,722
Amount paid for insurance broker fees5165
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number132962
Policy instance 4
Insurance contract or identification number132962
Number of Individuals Covered70
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $1,596
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedHOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $4,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,596
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number71561-1
Policy instance 5
Insurance contract or identification number71561-1
Number of Individuals Covered50
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $8,572
Total amount of fees paid to insurance companyUSD $265
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $13,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,572
Amount paid for insurance broker fees265
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3

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