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CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 401k Plan overview

Plan NameCENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE
Plan identification number 501

CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CENTRA SOTA COOPERATIVE has sponsored the creation of one or more 401k plans.

Company Name:CENTRA SOTA COOPERATIVE
Employer identification number (EIN):410488480
NAIC Classification:115110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-10-01JEFF JOHNSON
5012015-10-01JEFF JOHNSON
5012014-10-01JEFF JOHNSON
5012013-10-01JEFF JOHNSON
5012012-10-01JEFF JOHNSON
5012011-10-01JEFF JOHNSON
5012010-10-01JEFF JOHNSON

Plan Statistics for CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE

401k plan membership statisitcs for CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE

Measure Date Value
2016: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-10-01142
Total number of active participants reported on line 7a of the Form 55002016-10-01138
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01138
2015: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-10-01142
Total number of active participants reported on line 7a of the Form 55002015-10-01142
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01142
2014: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-10-01130
Total number of active participants reported on line 7a of the Form 55002014-10-01142
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01142
2013: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-10-01116
Total number of active participants reported on line 7a of the Form 55002013-10-01130
Total of all active and inactive participants2013-10-01130
2012: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-10-01116
Total number of active participants reported on line 7a of the Form 55002012-10-01116
Total of all active and inactive participants2012-10-01116
2011: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-10-01107
Total number of active participants reported on line 7a of the Form 55002011-10-01116
Total of all active and inactive participants2011-10-01116
2010: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-10-0199
Total number of active participants reported on line 7a of the Form 55002010-10-01107
Total of all active and inactive participants2010-10-01107

Form 5500 Responses for CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE

2016: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes
2013: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2010: CENTRA SOTA COOPERATIVE - SHORT TERM DISABILITY ACCIDENTAL DEATH & DISBURSEMENT, LONG-TERM DISABILITY AND LIFE INSURANCE 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01First time form 5500 has been submittedYes
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number160514
Policy instance 1
Insurance contract or identification number160514
Number of Individuals Covered142
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $15,521
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,521
Insurance broker organization code?3
Insurance broker nameSHAWN W NELSON
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00343414
Policy instance 1
Insurance contract or identification number00343414
Number of Individuals Covered142
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $16,123
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $151,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,949
Insurance broker organization code?3
Insurance broker nameSTRATEGIC BENEFITS GROUP INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00343414
Policy instance 1
Insurance contract or identification number00343414
Number of Individuals Covered130
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $15,069
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $139,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,926
Insurance broker organization code?3
Insurance broker nameSTRATEGIC BENEFITS GROUP INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00343414
Policy instance 1
Insurance contract or identification number00343414
Number of Individuals Covered116
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $13,092
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,070
Insurance broker organization code?3
Insurance broker nameSTRATEGIC BENEFITS GROUP INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00343414
Policy instance 1
Insurance contract or identification number00343414
Number of Individuals Covered116
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $5,030
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,673
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 number00343414
Policy instance 1
Insurance contract or identification number00343414
Number of Individuals Covered107
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $5,975
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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