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NISSAN WELFARE BENEFIT PLAN 401k Plan overview

Plan NameNISSAN WELFARE BENEFIT PLAN
Plan identification number 501

NISSAN WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

NISSAN OF NORTH OLMSTED LLC has sponsored the creation of one or more 401k plans.

Company Name:NISSAN OF NORTH OLMSTED LLC
Employer identification number (EIN):383597513
NAIC Classification:441110
NAIC Description:New Car Dealers

Additional information about NISSAN OF NORTH OLMSTED LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3385180

More information about NISSAN OF NORTH OLMSTED LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NISSAN WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-06-01
5012021-06-01
5012020-06-01
5012019-06-01

Plan Statistics for NISSAN WELFARE BENEFIT PLAN

401k plan membership statisitcs for NISSAN WELFARE BENEFIT PLAN

Measure Date Value
2022: NISSAN WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01105
Total number of active participants reported on line 7a of the Form 55002022-06-0195
Number of retired or separated participants receiving benefits2022-06-011
Total of all active and inactive participants2022-06-0196
Total participants2022-06-0196
2021: NISSAN WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01100
Total number of active participants reported on line 7a of the Form 55002021-06-0166
Number of retired or separated participants receiving benefits2021-06-010
Total of all active and inactive participants2021-06-0166
Total participants2021-06-0166
2020: NISSAN WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01101
Total number of active participants reported on line 7a of the Form 55002020-06-0198
Number of retired or separated participants receiving benefits2020-06-012
Total of all active and inactive participants2020-06-01100
Total participants2020-06-01100
2019: NISSAN WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01122
Total number of active participants reported on line 7a of the Form 55002019-06-0161
Number of retired or separated participants receiving benefits2019-06-011
Total of all active and inactive participants2019-06-0162
Total participants2019-06-0162

Form 5500 Responses for NISSAN WELFARE BENEFIT PLAN

2022: NISSAN WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-06-01Type of plan entityMulitple employer plan
2022-06-01Submission has been amendedNo
2022-06-01This submission is the final filingNo
2022-06-01This return/report is a short plan year return/report (less than 12 months)No
2022-06-01Plan is a collectively bargained planNo
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – InsuranceYes
2021: NISSAN WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-06-01Type of plan entityMulitple employer plan
2021-06-01Submission has been amendedNo
2021-06-01This submission is the final filingNo
2021-06-01This return/report is a short plan year return/report (less than 12 months)No
2021-06-01Plan is a collectively bargained planNo
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes
2020: NISSAN WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-06-01Type of plan entityMulitple employer plan
2020-06-01Submission has been amendedNo
2020-06-01This submission is the final filingNo
2020-06-01This return/report is a short plan year return/report (less than 12 months)No
2020-06-01Plan is a collectively bargained planNo
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes
2019: NISSAN WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01First time form 5500 has been submittedYes
2019-06-01Submission has been amendedNo
2019-06-01This submission is the final filingNo
2019-06-01This return/report is a short plan year return/report (less than 12 months)No
2019-06-01Plan is a collectively bargained planNo
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number48141
Policy instance 1
Insurance contract or identification number48141
Number of Individuals Covered10
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $967
Total amount of fees paid to insurance companyUSD $303
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $19,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $967
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES PAID
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number48141
Policy instance 2
Insurance contract or identification number48141
Number of Individuals Covered23
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $1,681
Total amount of fees paid to insurance companyUSD $631
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $35,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,681
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES PAID
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number
Policy instance 3
Number of Individuals Covered89
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $28,154
Total amount of fees paid to insurance companyUSD $1,770
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $587,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,184
Amount paid for insurance broker fees1770
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number0098861-01
Policy instance 1
Insurance contract or identification number0098861-01
Number of Individuals Covered67
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $25,250
Total amount of fees paid to insurance companyUSD $10,622
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,250
Amount paid for insurance broker fees10622
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS & BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberOH2450
Policy instance 2
Insurance contract or identification numberOH2450
Number of Individuals Covered58
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $618
Total amount of fees paid to insurance companyUSD $2,048
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $618
Amount paid for insurance broker fees2048
Additional information about fees paid to insurance brokerBONUS, OVERRIDES, NON MONETARY COMP
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number0098861-01
Policy instance 1
Insurance contract or identification number0098861-01
Number of Individuals Covered60
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $22,693
Total amount of fees paid to insurance companyUSD $18,917
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,693
Amount paid for insurance broker fees18917
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS & BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberOH2450
Policy instance 2
Insurance contract or identification numberOH2450
Number of Individuals Covered50
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $2,821
Total amount of fees paid to insurance companyUSD $2,358
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,821
Amount paid for insurance broker fees2358
Additional information about fees paid to insurance brokerBONUS, OVERRIDES, NON MONETARY COMP
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY, DBA ANTHEM BLUE CROSS & BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberOH2450
Policy instance 1
Insurance contract or identification numberOH2450
Number of Individuals Covered62
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $23,756
Total amount of fees paid to insurance companyUSD $7,971
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $459,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,050
Amount paid for insurance broker fees4725
Additional information about fees paid to insurance brokerBONUS, OVERRIDES, NON MONETARY COMP
Insurance broker organization code?3

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