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MEDICAL PLAN FOR CLOSERLOOK, INC. 401k Plan overview

Plan NameMEDICAL PLAN FOR CLOSERLOOK, INC.
Plan identification number 503

MEDICAL PLAN FOR CLOSERLOOK, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

CLOSERLOOK, INC. has sponsored the creation of one or more 401k plans.

Company Name:CLOSERLOOK, INC.
Employer identification number (EIN):364003276
NAIC Classification:541800

Additional information about CLOSERLOOK, INC.

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 2017-10-25
Company Identification Number: 136817590
Legal Registered Office Address: 2100 SOUTHEAST BELMONT STREET

PORTLAND
United States of America (USA)
97214

More information about CLOSERLOOK, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL PLAN FOR CLOSERLOOK, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032016-05-15JOANNA KONTOUDAKIS
5032015-05-15JOANNA KONTOUDAKIS
5032014-05-15JOANNA KONTOUDAKIS JOANNA KONTOUDAKIS2015-12-17

Plan Statistics for MEDICAL PLAN FOR CLOSERLOOK, INC.

401k plan membership statisitcs for MEDICAL PLAN FOR CLOSERLOOK, INC.

Measure Date Value
2016: MEDICAL PLAN FOR CLOSERLOOK, INC. 2016 401k membership
Total participants, beginning-of-year2016-05-15146
Total number of active participants reported on line 7a of the Form 55002016-05-150
Number of retired or separated participants receiving benefits2016-05-150
Number of other retired or separated participants entitled to future benefits2016-05-150
Total of all active and inactive participants2016-05-150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-05-150
2015: MEDICAL PLAN FOR CLOSERLOOK, INC. 2015 401k membership
Total participants, beginning-of-year2015-05-15107
Total number of active participants reported on line 7a of the Form 55002015-05-15146
Number of retired or separated participants receiving benefits2015-05-154
Number of other retired or separated participants entitled to future benefits2015-05-150
Total of all active and inactive participants2015-05-15150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-05-150
2014: MEDICAL PLAN FOR CLOSERLOOK, INC. 2014 401k membership
Total participants, beginning-of-year2014-05-15101
Total number of active participants reported on line 7a of the Form 55002014-05-15107
Number of retired or separated participants receiving benefits2014-05-150
Number of other retired or separated participants entitled to future benefits2014-05-150
Total of all active and inactive participants2014-05-15107

Form 5500 Responses for MEDICAL PLAN FOR CLOSERLOOK, INC.

2016: MEDICAL PLAN FOR CLOSERLOOK, INC. 2016 form 5500 responses
2016-05-15Type of plan entitySingle employer plan
2016-05-15Submission has been amendedNo
2016-05-15This submission is the final filingYes
2016-05-15This return/report is a short plan year return/report (less than 12 months)Yes
2016-05-15Plan is a collectively bargained planNo
2016-05-15Plan funding arrangement – InsuranceYes
2016-05-15Plan benefit arrangement – InsuranceYes
2015: MEDICAL PLAN FOR CLOSERLOOK, INC. 2015 form 5500 responses
2015-05-15Type of plan entitySingle employer plan
2015-05-15Submission has been amendedNo
2015-05-15This submission is the final filingNo
2015-05-15This return/report is a short plan year return/report (less than 12 months)No
2015-05-15Plan is a collectively bargained planNo
2015-05-15Plan funding arrangement – InsuranceYes
2015-05-15Plan benefit arrangement – InsuranceYes
2014: MEDICAL PLAN FOR CLOSERLOOK, INC. 2014 form 5500 responses
2014-05-15Type of plan entitySingle employer plan
2014-05-15First time form 5500 has been submittedYes
2014-05-15Submission has been amendedNo
2014-05-15This submission is the final filingNo
2014-05-15This return/report is a short plan year return/report (less than 12 months)No
2014-05-15Plan is a collectively bargained planNo
2014-05-15Plan funding arrangement – InsuranceYes
2014-05-15Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP00647
Policy instance 1
Insurance contract or identification numberP00647
Number of Individuals Covered0
Insurance policy start date2016-05-15
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $62,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP00647
Policy instance 1
Insurance contract or identification numberP00647
Number of Individuals Covered245
Insurance policy start date2015-05-15
Insurance policy end date2016-05-14
Total amount of commissions paid to insurance brokerUSD $45,751
Total amount of fees paid to insurance companyUSD $2,375
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,190,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,751
Amount paid for insurance broker fees2375
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameASSURANCE AGENCY
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP00647
Policy instance 1
Insurance contract or identification numberP00647
Number of Individuals Covered196
Insurance policy start date2014-05-15
Insurance policy end date2015-05-14
Total amount of commissions paid to insurance brokerUSD $38,651
Total amount of fees paid to insurance companyUSD $2,842
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $884,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,294
Insurance broker organization code?3
Amount paid for insurance broker fees2450
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker nameRESOURCE BROKERAGE

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