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METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 401k Plan overview

Plan NameMETRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN
Plan identification number 502

METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

METRO MOLD & DESIGN INC has sponsored the creation of one or more 401k plans.

Company Name:METRO MOLD & DESIGN INC
Employer identification number (EIN):411314740
NAIC Classification:339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022016-07-01GREG ULBERG GREG ULBERG2017-06-28
5022015-07-01GREG ULBERG GREG ULBERG2017-02-10
5022014-07-01GREG ULBERG GREG ULBERG2016-04-11
5022013-07-01VALERIE TAZELAAR VALERIE TAZELAAR2015-02-05
5022012-07-01VALERIE TAZELAAR VALERIE TAZELAAR2014-01-29
5022011-07-01VALERIE TAZELAAR
5022009-07-01SHANNON PRAMANN

Plan Statistics for METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN

401k plan membership statisitcs for METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN

Measure Date Value
2016: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01192
Total number of active participants reported on line 7a of the Form 55002016-07-01206
Number of retired or separated participants receiving benefits2016-07-011
Total of all active and inactive participants2016-07-01207
2015: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01241
Total number of active participants reported on line 7a of the Form 55002015-07-01188
Number of retired or separated participants receiving benefits2015-07-011
Total of all active and inactive participants2015-07-01189
2014: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01295
Total number of active participants reported on line 7a of the Form 55002014-07-01237
Number of retired or separated participants receiving benefits2014-07-0110
Total of all active and inactive participants2014-07-01247
2013: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01259
Total number of active participants reported on line 7a of the Form 55002013-07-01306
Number of retired or separated participants receiving benefits2013-07-011
Total of all active and inactive participants2013-07-01307
2012: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01242
Total number of active participants reported on line 7a of the Form 55002012-07-01208
Number of retired or separated participants receiving benefits2012-07-0138
Total of all active and inactive participants2012-07-01246
2011: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01163
Total number of active participants reported on line 7a of the Form 55002011-07-01232
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01232
2009: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01166
Total number of active participants reported on line 7a of the Form 55002009-07-01138
Number of retired or separated participants receiving benefits2009-07-012
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01140

Form 5500 Responses for METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN

2016: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: METRO MOLD & DESIGN INC EMPLOYEE ANCILLARY BENEFIT PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5440131
Policy instance 1
Insurance contract or identification number5440131
Number of Individuals Covered114
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $11,771
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $96,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,655
Insurance broker organization code?3
Additional information about fees paid to insurance brokerMARKETING FEE, NON MONETARY COMP, PRODUCTION BONUS
Insurance broker nameRJF AGENCIES INC
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9910720
Policy instance 3
Insurance contract or identification number9910720
Number of Individuals Covered129
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $782
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $782
Insurance broker organization code?3
Insurance broker nameRJF A MARSH & MCLENNAN AGENCY LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966064
Policy instance 2
Insurance contract or identification numberFLX966064
Number of Individuals Covered189
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $13,312
Total amount of fees paid to insurance companyUSD $6,529
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $99,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,312
Amount paid for insurance broker fees6529
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5440131
Policy instance 1
Insurance contract or identification number5440131
Number of Individuals Covered150
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $12,306
Total amount of fees paid to insurance companyUSD $68
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $123,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,306
Insurance broker organization code?3
Amount paid for insurance broker fees68
Additional information about fees paid to insurance brokerNON MONETOARY COMP
Insurance broker nameRJF AGENCIES INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966064
Policy instance 2
Insurance contract or identification numberFLX966064
Number of Individuals Covered241
Insurance policy start date2014-07-01
Insurance policy end date2015-07-01
Total amount of commissions paid to insurance brokerUSD $16,473
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
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $123,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,473
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9910720
Policy instance 3
Insurance contract or identification number9910720
Number of Individuals Covered155
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $964
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $964
Insurance broker organization code?3
Insurance broker nameRJF A MARSH & MCLENNAN AGENCY LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5440131
Policy instance 1
Insurance contract or identification number5440131
Number of Individuals Covered306
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $30,436
Total amount of fees paid to insurance companyUSD $13,905
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $284,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,436
Amount paid for insurance broker fees13905
Insurance broker organization code?3
Insurance broker nameRFJ A MARSH & MCLENNAN AGENCY LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5440131
Policy instance 1
Insurance contract or identification number5440131
Number of Individuals Covered246
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $30,078
Total amount of fees paid to insurance companyUSD $6,515
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $258,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,125
Amount paid for insurance broker fees6515
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameRFJ A MARSH & MCLENNAN AGENCY LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5440131
Policy instance 1
Insurance contract or identification number5440131
Number of Individuals Covered265
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $59,024
Total amount of fees paid to insurance companyUSD $20,445
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $501,311
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5440131
Policy instance 1
Insurance contract or identification number5440131
Number of Individuals Covered163
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $21,678
Total amount of fees paid to insurance companyUSD $3,796
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $175,944

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