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MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 401k Plan overview

Plan NameMITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS
Plan identification number 601

MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

MITSUBISHI MOTORS R AND D OF AMERICA, INC has sponsored the creation of one or more 401k plans.

Company Name:MITSUBISHI MOTORS R AND D OF AMERICA, INC
Employer identification number (EIN):371353100
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
6012016-07-01CHRISTINE GRYSBAN
6012015-07-01CHRISTINE GRYSBAN
6012014-07-01PAULETTE R. MILLER, CPA
6012013-07-01CHRISTINE GRYSBAN
6012012-07-01CHRISTINE GRYSBAN
6012011-07-01CHRISTINE GRYSBAN
6012009-07-01CHRISTINE GRYSBAN

Plan Statistics for MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS

401k plan membership statisitcs for MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS

Measure Date Value
2016: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2016 401k membership
Total participants, beginning-of-year2016-07-0156
Total number of active participants reported on line 7a of the Form 55002016-07-0135
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-0135
2015: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2015 401k membership
Total participants, beginning-of-year2015-07-0175
Total number of active participants reported on line 7a of the Form 55002015-07-0156
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-0156
2014: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2014 401k membership
Total participants, beginning-of-year2014-07-0173
Total number of active participants reported on line 7a of the Form 55002014-07-0175
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-0175
2013: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2013 401k membership
Total participants, beginning-of-year2013-07-0177
Total number of active participants reported on line 7a of the Form 55002013-07-0173
Number of retired or separated participants receiving benefits2013-07-010
Total of all active and inactive participants2013-07-0173
2012: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2012 401k membership
Total participants, beginning-of-year2012-07-0177
Total number of active participants reported on line 7a of the Form 55002012-07-0177
Number of retired or separated participants receiving benefits2012-07-010
Total of all active and inactive participants2012-07-0177
2011: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2011 401k membership
Total participants, beginning-of-year2011-07-0173
Total number of active participants reported on line 7a of the Form 55002011-07-0177
Number of retired or separated participants receiving benefits2011-07-010
Total of all active and inactive participants2011-07-0177
2009: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2009 401k membership
Total participants, beginning-of-year2009-07-01144
Total number of active participants reported on line 7a of the Form 55002009-07-0174
Number of retired or separated participants receiving benefits2009-07-0115
Total of all active and inactive participants2009-07-0189

Form 5500 Responses for MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS

2016: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes
2013: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – General assets of the sponsorYes
2012: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – General assets of the sponsorYes
2011: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – General assets of the sponsorYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – General assets of the sponsorYes
2009: MITSUBISHI MOTORS R&D OF AMERICA, INC. CONSOLIDATED PLAN DOCUMENT FOR CERTAIN WELFARE BENEFIT PLANS 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – General assets of the sponsorYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AT18
Policy instance 3
Insurance contract or identification numberG000AT18
Number of Individuals Covered30
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $223
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,462
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $223
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameJ. DEMPSEY INCORPORATED
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AT18
Policy instance 2
Insurance contract or identification numberG000AT18
Number of Individuals Covered30
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $933
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $933
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameJ. DEMPSEY INCORPORATED
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number46901
Policy instance 1
Insurance contract or identification number46901
Number of Individuals Covered155
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $8,930
Total amount of fees paid to insurance companyUSD $15,175
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,930
Amount paid for insurance broker fees15175
Insurance broker organization code?3
Insurance broker nameJ DEMPSEY INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AT18
Policy instance 3
Insurance contract or identification numberG000AT18
Number of Individuals Covered32
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $229
Total amount of fees paid to insurance companyUSD $54
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $229
Amount paid for insurance broker fees54
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameJ. DEMPSEY INCORPORATED
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number46901
Policy instance 1
Insurance contract or identification number46901
Number of Individuals Covered173
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $9,703
Total amount of fees paid to insurance companyUSD $15,516
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,703
Amount paid for insurance broker fees15516
Insurance broker organization code?3
Insurance broker nameJ DEMPSEY INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AT18
Policy instance 2
Insurance contract or identification numberG000AT18
Number of Individuals Covered32
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $969
Total amount of fees paid to insurance companyUSD $114
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $969
Amount paid for insurance broker fees114
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameJ. DEMPSEY INCORPORATED
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number46901
Policy instance 1
Insurance contract or identification number46901
Number of Individuals Covered181
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $10,524
Total amount of fees paid to insurance companyUSD $16,957
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $819,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,524
Amount paid for insurance broker fees16957
Insurance broker organization code?3
Insurance broker nameJ DEMPSEY INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010161744
Policy instance 2
Insurance contract or identification number000010161744
Number of Individuals Covered34
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $1,122
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,122
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameJ. DEMPSEY INCORPORATED
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010161745
Policy instance 3
Insurance contract or identification number000010161745
Number of Individuals Covered34
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $663
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $663
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameJ. DEMPSEY INCORPORATED
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number46901
Policy instance 1
Insurance contract or identification number46901
Number of Individuals Covered185
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $29,716
Total amount of fees paid to insurance companyUSD $2,406
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $934,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,716
Amount paid for insurance broker fees2406
Insurance broker nameJ DEMPSEY INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010161745
Policy instance 3
Insurance contract or identification number000010161745
Number of Individuals Covered37
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $1,144
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,624
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,144
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameJ. DEMPSEY INCORPORATED
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010161744
Policy instance 2
Insurance contract or identification number000010161744
Number of Individuals Covered37
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $1,684
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $15,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,684
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameJ. DEMPSEY INCORPORATED
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number46901
Policy instance 1
Insurance contract or identification number46901
Number of Individuals Covered196
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $30,906
Total amount of fees paid to insurance companyUSD $2,409
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $755,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00449454
Policy instance 2
Insurance contract or identification number00449454
Number of Individuals Covered78
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $5,439
Total amount of fees paid to insurance companyUSD $2,337
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $82,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number46901
Policy instance 1
Insurance contract or identification number46901
Number of Individuals Covered214
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $37,242
Total amount of fees paid to insurance companyUSD $2,294
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $715,330
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00449454
Policy instance 2
Insurance contract or identification number00449454
Number of Individuals Covered37
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,949
Total amount of fees paid to insurance companyUSD $485
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $13,577
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NIPPON LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 81264 )
Policy contract numberQ3742
Policy instance 3
Insurance contract or identification numberQ3742
Number of Individuals Covered120
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $3,114
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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