401k Plan data: GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN plan

GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN
Plan identification number	501

GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

AMERITI MANUFACTURING COMPANY has sponsored the creation of one or more 401k plans.

Company Name: AMERITI MANUFACTURING COMPANY

Employer identification number (EIN): 382513566

NAIC Classification: 339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 ROBERT VROOMAN 2021-07-19

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-01-01	ROBERT VROOMAN	2021-07-19

Plan Statistics for GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN

Measure Date Value
2020: GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 109
Total of all active and inactive participants 2020-01-01 109

Measure	Date	Value
2020: GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	109
Total of all active and inactive participants	2020-01-01	109

Form 5500 Responses for GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN

2020: GLOBAL TITANIUM, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	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

135382

Policy instance

Insurance contract or identification number	135382
Number of Individuals Covered	74
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $22,758
Total amount of fees paid to insurance company	USD $294
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,758
Amount paid for insurance broker fees	294
Insurance broker organization code?	3

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

Policy contract number

135382

Policy instance

Insurance contract or identification number	135382
Number of Individuals Covered	208
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $43,101
Total amount of fees paid to insurance company	USD $624
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $43,101
Amount paid for insurance broker fees	624
Insurance broker organization code?	3

DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )

Policy contract number

0002966

Policy instance

Insurance contract or identification number	0002966
Number of Individuals Covered	282
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $6,139
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,139
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

408144

Policy instance

Insurance contract or identification number	408144
Number of Individuals Covered	113
Insurance policy start date	2020-01-01
Insurance policy end date	2021-01-01
Total amount of commissions paid to insurance broker	USD $10,554
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $139,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,554
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

Potentially related plans

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Company Name:	AMERITI MANUFACTURING COMPANY
Employer identification number (EIN):	382513566
NAIC Classification:	339900