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ACCENT DECOR INC. WELFARE BENEFITS PLAN 401k Plan overview

Plan NameACCENT DECOR INC. WELFARE BENEFITS PLAN
Plan identification number 501

ACCENT DECOR INC. WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:ACCENT DECOR, INC.
Employer identification number (EIN):383067276
NAIC Classification:541400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ACCENT DECOR INC. WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01SANDRA STAUFER2023-10-02
5012021-10-01
5012020-10-01
5012019-10-01

Plan Statistics for ACCENT DECOR INC. WELFARE BENEFITS PLAN

401k plan membership statisitcs for ACCENT DECOR INC. WELFARE BENEFITS PLAN

Measure Date Value
2022: ACCENT DECOR INC. WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01102
Total number of active participants reported on line 7a of the Form 55002022-01-0187
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0187
Number of employers contributing to the scheme2022-01-010
2021: ACCENT DECOR INC. WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-0181
Total number of active participants reported on line 7a of the Form 55002021-10-01102
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01102
2020: ACCENT DECOR INC. WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-0165
Total number of active participants reported on line 7a of the Form 55002020-10-0180
Number of retired or separated participants receiving benefits2020-10-011
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-0181
2019: ACCENT DECOR INC. WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01105
Total number of active participants reported on line 7a of the Form 55002019-10-01105
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01105

Financial Data on ACCENT DECOR INC. WELFARE BENEFITS PLAN

Measure Date Value
2022 : ACCENT DECOR INC. WELFARE BENEFITS PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$138,636
Total plan liabilities at beginning of year2022-12-31$116,266
Total income from all sources2022-12-31$1,079,274
Expenses. Total of all expenses incurred2022-12-31$1,046,095
Benefits paid (including direct rollovers)2022-12-31$687,064
Total plan assets at end of year2022-12-31$60,590
Total plan assets at beginning of year2022-12-31$5,041
Value of fidelity bond covering the plan2022-12-31$250,000
Total contributions received or receivable from participants2022-12-31$310,833
Expenses. Other expenses not covered elsewhere2022-12-31$346,041
Net income (gross income less expenses)2022-12-31$33,179
Net plan assets at end of year (total assets less liabilities)2022-12-31$-78,046
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$-111,225
Total contributions received or receivable from employer(s)2022-12-31$768,441
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$12,990
2021 : ACCENT DECOR INC. WELFARE BENEFITS PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$116,266
Total plan liabilities at beginning of year2021-12-31$62,364
Total income from all sources2021-12-31$212,330
Expenses. Total of all expenses incurred2021-12-31$266,266
Benefits paid (including direct rollovers)2021-12-31$180,044
Total plan assets at end of year2021-12-31$5,041
Total plan assets at beginning of year2021-12-31$5,075
Value of fidelity bond covering the plan2021-12-31$250,000
Total contributions received or receivable from participants2021-12-31$54,636
Expenses. Other expenses not covered elsewhere2021-12-31$83,408
Net income (gross income less expenses)2021-12-31$-53,936
Net plan assets at end of year (total assets less liabilities)2021-12-31$-111,225
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$-57,289
Total contributions received or receivable from employer(s)2021-12-31$157,694
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$2,814
Total plan liabilities at end of year2021-09-30$62,364
Total income from all sources2021-09-30$748,838
Expenses. Total of all expenses incurred2021-09-30$806,127
Benefits paid (including direct rollovers)2021-09-30$503,566
Total plan assets at end of year2021-09-30$5,075
Value of fidelity bond covering the plan2021-09-30$250,000
Total contributions received or receivable from participants2021-09-30$263,641
Expenses. Other expenses not covered elsewhere2021-09-30$292,701
Contributions received from other sources (not participants or employers)2021-09-30$0
Other income received2021-09-30$0
Net income (gross income less expenses)2021-09-30$-57,289
Net plan assets at end of year (total assets less liabilities)2021-09-30$-57,289
Net plan assets at beginning of year (total assets less liabilities)2021-09-30$0
Total contributions received or receivable from employer(s)2021-09-30$485,197
Expenses. Administrative service providers (salaries,fees and commissions)2021-09-30$9,860

Form 5500 Responses for ACCENT DECOR INC. WELFARE BENEFITS PLAN

2022: ACCENT DECOR INC. WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: ACCENT DECOR INC. WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – TrustYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement - TrustYes
2020: ACCENT DECOR INC. WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Submission has been amendedNo
2020-10-01This submission is the final filingNo
2020-10-01This return/report is a short plan year return/report (less than 12 months)No
2020-10-01Plan is a collectively bargained planNo
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – TrustYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement - TrustYes
2019: ACCENT DECOR INC. WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01First time form 5500 has been submittedYes
2019-10-01Submission has been amendedYes
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberSL30500620-221
Policy instance 1
Insurance contract or identification numberSL30500620-221
Number of Individuals Covered87
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $268,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500620
Policy instance 1
Insurance contract or identification number30500620
Number of Individuals Covered102
Insurance policy start date2021-10-01
Insurance policy end date2021-12-31
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 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 BenefitNo
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 $65,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500620
Policy instance 1
Insurance contract or identification number30500620
Number of Individuals Covered80
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
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 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 BenefitNo
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 $231,508
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 number00553420
Policy instance 1
Insurance contract or identification number00553420
Number of Individuals Covered105
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $12,059
Total amount of fees paid to insurance companyUSD $5,711
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 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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, OPTIONAL AD&D, OPTIONAL LIFE
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 $102,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,447
Amount paid for insurance broker fees5711
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number234615
Policy instance 2
Insurance contract or identification number234615
Number of Individuals Covered32
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $3,955
Total amount of fees paid to insurance companyUSD $405
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 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 $76,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,955
Amount paid for insurance broker fees405
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00627092
Policy instance 3
Insurance contract or identification number00627092
Number of Individuals Covered63
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $34,278
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 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 $655,559
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 fees19236
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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