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CUSTOM GLASS LIFE AND ADD 401k Plan overview

Plan NameCUSTOM GLASS LIFE AND ADD
Plan identification number 504

CUSTOM GLASS LIFE AND ADD Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • 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

CUSTOM GLASS SOLUTIONS UPPER SANDUSKY LLC has sponsored the creation of one or more 401k plans.

Company Name:CUSTOM GLASS SOLUTIONS UPPER SANDUSKY LLC
Employer identification number (EIN):352476454
NAIC Classification:327210

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CUSTOM GLASS LIFE AND ADD

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-11-01AMANDA WILLIS2023-06-22
5042021-11-01AMANDA WILLIS2023-06-22
5042020-11-01LAUREN CREASAP2022-01-07
5042019-11-01LAUREN CREASAP2021-05-17
5042018-11-01LAUREN CREASAP2021-05-17
5042018-10-01LAUREN CREASAP2021-05-17

Plan Statistics for CUSTOM GLASS LIFE AND ADD

401k plan membership statisitcs for CUSTOM GLASS LIFE AND ADD

Measure Date Value
2022: CUSTOM GLASS LIFE AND ADD 2022 401k membership
Total participants, beginning-of-year2022-11-01626
Total number of active participants reported on line 7a of the Form 55002022-11-01728
Number of retired or separated participants receiving benefits2022-11-010
Number of other retired or separated participants entitled to future benefits2022-11-010
Total of all active and inactive participants2022-11-01728
Number of employers contributing to the scheme2022-11-010
2021: CUSTOM GLASS LIFE AND ADD 2021 401k membership
Total participants, beginning-of-year2021-11-01397
Total number of active participants reported on line 7a of the Form 55002021-11-01626
Number of retired or separated participants receiving benefits2021-11-010
Number of other retired or separated participants entitled to future benefits2021-11-010
Total of all active and inactive participants2021-11-01626
Number of employers contributing to the scheme2021-11-010
2020: CUSTOM GLASS LIFE AND ADD 2020 401k membership
Total participants, beginning-of-year2020-11-01359
Total number of active participants reported on line 7a of the Form 55002020-11-01397
Number of retired or separated participants receiving benefits2020-11-010
Number of other retired or separated participants entitled to future benefits2020-11-010
Total of all active and inactive participants2020-11-01397
Number of employers contributing to the scheme2020-11-010
2019: CUSTOM GLASS LIFE AND ADD 2019 401k membership
Total participants, beginning-of-year2019-11-01398
Total number of active participants reported on line 7a of the Form 55002019-11-01359
Number of retired or separated participants receiving benefits2019-11-010
Number of other retired or separated participants entitled to future benefits2019-11-010
Total of all active and inactive participants2019-11-01359
Number of employers contributing to the scheme2019-11-010
2018: CUSTOM GLASS LIFE AND ADD 2018 401k membership
Total participants, beginning-of-year2018-11-01100
Total number of active participants reported on line 7a of the Form 55002018-11-01398
Number of retired or separated participants receiving benefits2018-11-010
Number of other retired or separated participants entitled to future benefits2018-11-010
Total of all active and inactive participants2018-11-01398
Number of employers contributing to the scheme2018-11-010
Total participants, beginning-of-year2018-10-01100
Total number of active participants reported on line 7a of the Form 55002018-10-01100
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01100
Number of employers contributing to the scheme2018-10-010

Form 5500 Responses for CUSTOM GLASS LIFE AND ADD

2022: CUSTOM GLASS LIFE AND ADD 2022 form 5500 responses
2022-11-01Type of plan entitySingle employer plan
2022-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-11-01Plan funding arrangement – InsuranceYes
2022-11-01Plan funding arrangement – General assets of the sponsorYes
2022-11-01Plan benefit arrangement – InsuranceYes
2022-11-01Plan benefit arrangement – General assets of the sponsorYes
2021: CUSTOM GLASS LIFE AND ADD 2021 form 5500 responses
2021-11-01Type of plan entitySingle employer plan
2021-11-01Plan funding arrangement – InsuranceYes
2021-11-01Plan funding arrangement – General assets of the sponsorYes
2021-11-01Plan benefit arrangement – InsuranceYes
2021-11-01Plan benefit arrangement – General assets of the sponsorYes
2020: CUSTOM GLASS LIFE AND ADD 2020 form 5500 responses
2020-11-01Type of plan entitySingle employer plan
2020-11-01Plan funding arrangement – InsuranceYes
2020-11-01Plan benefit arrangement – InsuranceYes
2019: CUSTOM GLASS LIFE AND ADD 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – InsuranceYes
2018: CUSTOM GLASS LIFE AND ADD 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – InsuranceYes
2018-10-01Type of plan entitySingle employer plan
2018-10-01First time form 5500 has been submittedYes
2018-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan 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 number26020
Policy instance 1
Insurance contract or identification number26020
Number of Individuals Covered728
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,528
Total amount of fees paid to insurance companyUSD $125
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $289,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,528
Amount paid for insurance broker fees125
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number26020
Policy instance 1
Insurance contract or identification number26020
Number of Individuals Covered626
Insurance policy start date2021-11-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5955155
Policy instance 1
Insurance contract or identification number5955155
Number of Individuals Covered933
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $66
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $243,069
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 fees53
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5955155
Policy instance 1
Insurance contract or identification number5955155
Number of Individuals Covered844
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $77
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $274,886
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 fees77
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5955155
Policy instance 1
Insurance contract or identification number5955155
Number of Individuals Covered398
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $90
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $157,692
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 fees90
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5955155
Policy instance 1
Insurance contract or identification number5955155
Number of Individuals Covered100
Insurance policy start date2018-10-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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