ASHTABULA RUBBER COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION
401k plan membership statisitcs for ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION
| Measure | Date | Value |
|---|
| 2020: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 187 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 159 |
| Total of all active and inactive participants | 2020-01-01 | 159 |
| 2019: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 194 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 187 |
| Total of all active and inactive participants | 2019-01-01 | 187 |
| 2018: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 208 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 194 |
| Total of all active and inactive participants | 2018-01-01 | 194 |
| 2017: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 208 |
| Total of all active and inactive participants | 2017-01-01 | 208 |
| 2016: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 126 |
| Total of all active and inactive participants | 2016-01-01 | 126 |
| 2013: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-08-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-08-01 | 114 |
| Total of all active and inactive participants | 2013-08-01 | 114 |
| Total participants | 2013-08-01 | 114 |
| 2020: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2020 form 5500 responses |
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| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: ASHTABULA RUBBER CO AD&D, LIFE, OPTIONAL LIFE, STD, VISION 2013 form 5500 responses |
|---|
| 2013-08-01 | Type of plan entity | Single employer plan |
| 2013-08-01 | Submission has been amended | No |
| 2013-08-01 | This submission is the final filing | No |
| 2013-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-08-01 | Plan is a collectively bargained plan | No |
| 2013-08-01 | Plan funding arrangement – Insurance | Yes |
| 2013-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-08-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GVTL0BRJX |
| Policy instance | 6 |
| Insurance contract or identification number | GVTL0BRJX | | Number of Individuals Covered | 33 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $654 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,360 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $654 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
| Policy contract number | 0106606HNO |
| Policy instance | 2 |
| Insurance contract or identification number | 0106606HNO | | Number of Individuals Covered | 159 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,504,858 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0BRJX |
| Policy instance | 3 |
| Insurance contract or identification number | GLTD0BRJX | | Number of Individuals Covered | 26 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $242 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,614 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $242 | | Insurance broker organization code? | 3 |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00396315 |
| Policy instance | 1 |
| Insurance contract or identification number | 00396315 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $5,415 | | Total amount of fees paid to insurance company | USD $3,179 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $36,236 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,415 | | Amount paid for insurance broker fees | 3179 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0BRJX |
| Policy instance | 4 |
| Insurance contract or identification number | GLUG0BRJX | | Number of Individuals Covered | 115 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $391 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $3,906 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $391 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GUG 0BRJX |
| Policy instance | 5 |
| Insurance contract or identification number | GUG 0BRJX | | Number of Individuals Covered | 89 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $846 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,457 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $846 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
| Policy contract number | 0106606HNO |
| Policy instance | 2 |
| Insurance contract or identification number | 0106606HNO | | Number of Individuals Covered | 186 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $52,917 | | Total amount of fees paid to insurance company | USD $28 | | Welfare Benefit Premiums Paid to Carrier | USD $1,634,718 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $52,917 | | Amount paid for insurance broker fees | 28 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00396315 |
| Policy instance | 1 |
| Insurance contract or identification number | 00396315 | | Number of Individuals Covered | 139 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $8,220 | | Total amount of fees paid to insurance company | USD $3,679 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $55,633 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,220 | | Amount paid for insurance broker fees | 3679 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00396315 |
| Policy instance | 4 |
| Insurance contract or identification number | 00396315 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,873 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $13,235 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,873 | | Insurance broker organization code? | 3 |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
| Policy contract number | 0106606HNO |
| Policy instance | 3 |
| Insurance contract or identification number | 0106606HNO | | Number of Individuals Covered | 187 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $12,431 | | Total amount of fees paid to insurance company | USD $231 | | Welfare Benefit Premiums Paid to Carrier | USD $398,603 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,431 | | Amount paid for insurance broker fees | 231 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
| Policy contract number | 0106606HNO |
| Policy instance | 2 |
| Insurance contract or identification number | 0106606HNO | | Number of Individuals Covered | 194 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $74,858 | | Total amount of fees paid to insurance company | USD $3,395 | | Welfare Benefit Premiums Paid to Carrier | USD $1,548,432 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $74,858 | | Amount paid for insurance broker fees | 3395 | | Additional information about fees paid to insurance broker | 2017 PPP ENGAGEMENT CREDIT-NEW BUSINESS MEDICAL | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00396315 |
| Policy instance | 1 |
| Insurance contract or identification number | 00396315 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $8,038 | | Total amount of fees paid to insurance company | USD $3,509 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $54,381 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,038 | | Amount paid for insurance broker fees | 3509 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 106606 |
| Policy instance | 3 |
| Insurance contract or identification number | 106606 | | Number of Individuals Covered | 208 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $12,770 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $383,569 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,770 | | Insurance broker organization code? | 3 | | Insurance broker name | THE FEDELI GROUP INC |
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| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) |
| Policy contract number | 00172840 |
| Policy instance | 2 |
| Insurance contract or identification number | 00172840 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-09-30 | | Total amount of commissions paid to insurance broker | USD $37,200 | | Total amount of fees paid to insurance company | USD $1,964 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $989,561 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,200 | | Amount paid for insurance broker fees | 1964 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | THE FEDELI GROUP INC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00396315 |
| Policy instance | 1 |
| Insurance contract or identification number | 00396315 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $7,878 | | Total amount of fees paid to insurance company | USD $1,746 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $51,242 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,878 | | Amount paid for insurance broker fees | 1746 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | THE FEDELI GROUP INC |
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