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CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 401k Plan overview

Plan NameCONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL)
Plan identification number 503

CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • 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

CONSTRUCTION FORMS, INC. has sponsored the creation of one or more 401k plans.

Company Name:CONSTRUCTION FORMS, INC.
Employer identification number (EIN):391104344
NAIC Classification:332900

Additional information about CONSTRUCTION FORMS, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2001-12-03
Company Identification Number: 0800032824
Legal Registered Office Address: PO BOX 308

PRT WASHINGTN
United States of America (USA)
53074

More information about CONSTRUCTION FORMS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL)

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01
5032019-01-01
5032018-01-01TERRY SKEBBA
5032017-01-01TERRY SKEBBA
5032016-01-01TERRY SKEBBA TERRY SKEBBA2017-06-26
5032015-01-01TERRY SKEBBA

Plan Statistics for CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL)

401k plan membership statisitcs for CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL)

Measure Date Value
2022: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2022 401k membership
Total participants, beginning-of-year2022-01-01102
Total number of active participants reported on line 7a of the Form 55002022-01-0199
Number of retired or separated participants receiving benefits2022-01-011
Total of all active and inactive participants2022-01-01100
2019: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2019 401k membership
Total participants, beginning-of-year2019-01-01103
Total number of active participants reported on line 7a of the Form 55002019-01-0191
Number of retired or separated participants receiving benefits2019-01-011
Total of all active and inactive participants2019-01-0192
2018: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2018 401k membership
Total participants, beginning-of-year2018-01-01112
Total number of active participants reported on line 7a of the Form 55002018-01-01105
Total of all active and inactive participants2018-01-01105
2017: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2017 401k membership
Total participants, beginning-of-year2017-01-01116
Total number of active participants reported on line 7a of the Form 55002017-01-01114
Total of all active and inactive participants2017-01-01114
2016: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2016 401k membership
Total participants, beginning-of-year2016-01-01111
Total number of active participants reported on line 7a of the Form 55002016-01-01114
Total of all active and inactive participants2016-01-01114
2015: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2015 401k membership
Total participants, beginning-of-year2015-01-01100
Total number of active participants reported on line 7a of the Form 55002015-01-01111
Total of all active and inactive participants2015-01-01111

Form 5500 Responses for CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL)

2022: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: CONSTRUCTION FORMS, INC. GROUP BENEFIT PLAN (MEDICAL) 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number923364
Policy instance 1
Insurance contract or identification number923364
Number of Individuals Covered104
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $23,032
Total amount of fees paid to insurance companyUSD $3,520
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $632,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $17,274
Insurance broker organization code?3
Amount paid for insurance broker fees3520
Additional information about fees paid to insurance brokerBONUS
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number923364
Policy instance 1
Insurance contract or identification number923364
Number of Individuals Covered94
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $19,067
Total amount of fees paid to insurance companyUSD $3,308
Welfare Benefit Premiums Paid to CarrierUSD $476,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,300
Insurance broker organization code?3
Amount paid for insurance broker fees3308
Additional information about fees paid to insurance brokerBONUS
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417006410236
Policy instance 1
Insurance contract or identification number417006410236
Number of Individuals Covered105
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $514,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417006410236
Policy instance 1
Insurance contract or identification number417006410236
Number of Individuals Covered114
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $524,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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