401k Plan data: CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN plan

CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN
Plan identification number	512

CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CRESCENT MANUFACTURING COMPANY has sponsored the creation of one or more 401k plans.

Company Name: CRESCENT MANUFACTURING COMPANY

Employer identification number (EIN): 341466700

NAIC Classification: 332900

Additional information about CRESCENT MANUFACTURING COMPANY

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: C0183184

More information about CRESCENT MANUFACTURING COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
512 2022-04-01 RHONDA TAYLOR 2023-05-02

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
512	2022-04-01	RHONDA TAYLOR	2023-05-02

Plan Statistics for CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2022: CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-04-01 100
Total number of active participants reported on line 7a of the Form 5500 2022-04-01 114
Number of retired or separated participants receiving benefits 2022-04-01 0
Number of other retired or separated participants entitled to future benefits 2022-04-01 0
Total of all active and inactive participants 2022-04-01 114
Number of employers contributing to the scheme 2022-04-01 0

Measure	Date	Value
2022: CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-04-01	100
Total number of active participants reported on line 7a of the Form 5500	2022-04-01	114
Number of retired or separated participants receiving benefits	2022-04-01	0
Number of other retired or separated participants entitled to future benefits	2022-04-01	0
Total of all active and inactive participants	2022-04-01	114
Number of employers contributing to the scheme	2022-04-01	0

Form 5500 Responses for CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN

2022: CRESCENT MANUFACTURING COMPANY HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-04-01	Type of plan entity	Single employer plan
2022-04-01	First time form 5500 has been submitted	Yes
2022-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-04-01	Plan funding arrangement – Insurance	Yes
2022-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-04-01	Plan benefit arrangement – Insurance	Yes
2022-04-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0BTFC

Policy instance

Insurance contract or identification number	GLUG0BTFC
Number of Individuals Covered	114
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,509
Total amount of fees paid to insurance company	USD $1,285
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $25,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,509
Amount paid for insurance broker fees	1028
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0BTFC

Policy instance

Insurance contract or identification number	GLTD0BTFC
Number of Individuals Covered	30
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $652
Total amount of fees paid to insurance company	USD $346
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $652
Amount paid for insurance broker fees	277
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0BTFC

Policy instance

Insurance contract or identification number	GVTL0BTFC
Number of Individuals Covered	9
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $637
Total amount of fees paid to insurance company	USD $287
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $637
Amount paid for insurance broker fees	230
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUDS0BTFC

Policy instance

Insurance contract or identification number	GUDS0BTFC
Number of Individuals Covered	52
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,502
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,502
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

Potentially related plans

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Company Name:	CRESCENT MANUFACTURING COMPANY
Employer identification number (EIN):	341466700
NAIC Classification:	332900

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	C0183184