401k Plan data: GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN plan

GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN
Plan identification number	501

GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare 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

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

Company Name: GUDENKAUF CORPORATION

Employer identification number (EIN): 310908234

NAIC Classification: 236200

Additional information about GUDENKAUF CORPORATION

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 1977-06-10

Company Identification Number: 499409

Legal Registered Office Address: 2679 MCKINLEY AVENUE
-
COLUMBUS
United States of America (USA)
43204

More information about GUDENKAUF CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 LEIGH-ANNE DUNCAN 2021-09-08

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-01-01	LEIGH-ANNE DUNCAN	2021-09-08

Plan Statistics for GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN

401k plan membership statisitcs for GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2020: GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 225
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 225
Number of employers contributing to the scheme 2020-01-01 0

Measure	Date	Value
2020: GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	225
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	225
Number of employers contributing to the scheme	2020-01-01	0

Form 5500 Responses for GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN

2020: GUDENKAUF CORPORATION HEALTH & WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00602198-0001

Policy instance

Insurance contract or identification number	G00602198-0001
Number of Individuals Covered	225
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $3,713
Total amount of fees paid to insurance company	USD $1,551
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $87,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $3,713
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	OTHER COMPENSATION

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

210730

Policy instance

Insurance contract or identification number	210730
Number of Individuals Covered	189
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $28,680
Total amount of fees paid to insurance company	USD $50,841
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,300,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $28,330
Amount paid for insurance broker fees	47483
Additional information about fees paid to insurance broker	DIRECT COMPENSATION
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10046511001

Policy instance

Insurance contract or identification number	10046511001
Number of Individuals Covered	167
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,102
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,038
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

32467

Policy instance

Insurance contract or identification number	32467
Number of Individuals Covered	47
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,194
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $10,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,194
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	GUDENKAUF CORPORATION
Employer identification number (EIN):	310908234
NAIC Classification:	236200

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	1977-06-10
Company Identification Number:	499409
Legal Registered Office Address:	2679 MCKINLEY AVENUE - COLUMBUS United States of America (USA) 43204