401k Plan data: UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN plan

UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN
Plan identification number	510

UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Other welfare benefit cover

401k Sponsoring company profile

UNIVERSAL CONTAINER CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: UNIVERSAL CONTAINER CORPORATION

Employer identification number (EIN): 382087365

NAIC Classification: 322200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2023-08-01
510 2023-08-01 JOSEPH MOOTER
510 2022-08-01 JOSEPH MOOTER
510 2021-08-01 JOSEPH MOOTER
510 2020-08-01 JOSEPH MOOTER

Plan Statistics for UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN

401k plan membership statisitcs for UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN

Measure Date Value
2023: UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year 2023-08-01 176
Total number of active participants reported on line 7a of the Form 5500 2023-08-01 194
Number of retired or separated participants receiving benefits 2023-08-01 0
Number of other retired or separated participants entitled to future benefits 2023-08-01 0
Total of all active and inactive participants 2023-08-01 194

Measure	Date	Value
2023: UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year	2023-08-01	176
Total number of active participants reported on line 7a of the Form 5500	2023-08-01	194
Number of retired or separated participants receiving benefits	2023-08-01	0
Number of other retired or separated participants entitled to future benefits	2023-08-01	0
Total of all active and inactive participants	2023-08-01	194

Form 5500 Responses for UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN

2023: UNIVERSAL CONTAINER CORPORATION HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-08-01	Type of plan entity	Single employer plan
2023-08-01	Submission has been amended	No
2023-08-01	This submission is the final filing	No
2023-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-08-01	Plan is a collectively bargained plan	No
2023-08-01	Plan funding arrangement – Insurance	Yes
2023-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

08389-116

Policy instance

Insurance contract or identification number	08389-116
Number of Individuals Covered	2
Insurance policy start date	2022-12-01
Insurance policy end date	2023-11-30
Total amount of commissions paid to insurance broker	USD $547
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10235101001-6

Policy instance

Insurance contract or identification number	10235101001-6
Number of Individuals Covered	107
Insurance policy start date	2023-08-01
Insurance policy end date	2024-07-31
Total amount of commissions paid to insurance broker	USD $834
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $8,503
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 number

110991

Policy instance

Insurance contract or identification number	110991
Number of Individuals Covered	119
Insurance policy start date	2023-08-01
Insurance policy end date	2024-07-31
Total amount of commissions paid to insurance broker	USD $41,920
Total amount of fees paid to insurance company	USD $1,217
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
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 number

007010743-0000

Policy instance

Insurance contract or identification number	007010743-0000
Number of Individuals Covered	2
Insurance policy start date	2022-12-01
Insurance policy end date	2023-11-30
Total amount of commissions paid to insurance broker	USD $1,327
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

933427

Policy instance

Insurance contract or identification number	933427
Number of Individuals Covered	194
Insurance policy start date	2023-08-01
Insurance policy end date	2024-07-31
Total amount of commissions paid to insurance broker	USD $5,808
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 Carrier	USD $89,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )

Policy contract number

00009268/0001

Policy instance

Insurance contract or identification number	00009268/0001
Number of Individuals Covered	17
Insurance policy start date	2022-12-01
Insurance policy end date	2023-11-30
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $59,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

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Company Name:	UNIVERSAL CONTAINER CORPORATION
Employer identification number (EIN):	382087365
NAIC Classification:	322200

Plan id#	Filing Submission Date	Name of Administrator
510	2023-08-01
510	2023-08-01	JOSEPH MOOTER
510	2022-08-01	JOSEPH MOOTER
510	2021-08-01	JOSEPH MOOTER
510	2020-08-01	JOSEPH MOOTER