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SOURCEONE CORP BENEFIT PLAN 401k Plan overview

Plan NameSOURCEONE CORP BENEFIT PLAN
Plan identification number 501

SOURCEONE CORP BENEFIT 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)

401k Sponsoring company profile

SOURCEONE CORP. has sponsored the creation of one or more 401k plans.

Company Name:SOURCEONE CORP.
Employer identification number (EIN):341939837
NAIC Classification:541600

Additional information about SOURCEONE CORP.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 2000-11-14
Company Identification Number: 1191764
Legal Registered Office Address: 2215 18TH STREET SW
-
AKRON
United States of America (USA)
443142321

More information about SOURCEONE CORP.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOURCEONE CORP BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-06-01CONSTANTA POPA2023-11-30
5012021-06-01CONSTANTA POPA2022-11-11

Plan Statistics for SOURCEONE CORP BENEFIT PLAN

401k plan membership statisitcs for SOURCEONE CORP BENEFIT PLAN

Measure Date Value
2022: SOURCEONE CORP BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01109
Total number of active participants reported on line 7a of the Form 55002022-06-01123
Number of retired or separated participants receiving benefits2022-06-010
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-01123
Number of employers contributing to the scheme2022-06-010
2021: SOURCEONE CORP BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01114
Total number of active participants reported on line 7a of the Form 55002021-06-01109
Number of retired or separated participants receiving benefits2021-06-010
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01109
Number of employers contributing to the scheme2021-06-010

Form 5500 Responses for SOURCEONE CORP BENEFIT PLAN

2022: SOURCEONE CORP BENEFIT PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan funding arrangement – General assets of the sponsorYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – General assets of the sponsorYes
2021: SOURCEONE CORP BENEFIT PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01First time form 5500 has been submittedYes
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number22046
Policy instance 1
Insurance contract or identification number22046
Number of Individuals Covered123
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $9,288
Total amount of fees paid to insurance companyUSD $2,490
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $49,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,791
Amount paid for insurance broker fees2490
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number928075
Policy instance 2
Insurance contract or identification number928075
Number of Individuals Covered113
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $6,210
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $44,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,210
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 number22046
Policy instance 1
Insurance contract or identification number22046
Number of Individuals Covered109
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $9,564
Total amount of fees paid to insurance companyUSD $1,717
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $51,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,021
Amount paid for insurance broker fees1717
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberL03105
Policy instance 2
Insurance contract or identification numberL03105
Number of Individuals Covered107
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $34,436
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $777,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,500
Amount paid for insurance broker fees0
Insurance broker organization code?3

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