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COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC. (CLUES) WELFARE BENEFITS PLAN 401k Plan overview

Plan NameCOMUNIDADES LATINAS UNIDAS EN SERVICIO, INC. (CLUES) WELFARE BENEFITS PLAN
Plan identification number 507

COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC. (CLUES) WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

COMUNIDADES LATINAS UNIDAS EN SERVI CIO, INC. has sponsored the creation of one or more 401k plans.

Company Name:COMUNIDADES LATINAS UNIDAS EN SERVI CIO, INC.
Employer identification number (EIN):411386986
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC. (CLUES) WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072022-01-01BRENNA OUEDRAOGO2023-12-05

Plan Statistics for COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC. (CLUES) WELFARE BENEFITS PLAN

401k plan membership statisitcs for COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC. (CLUES) WELFARE BENEFITS PLAN

Measure Date Value
2022: COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC. (CLUES) WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01100
Total number of active participants reported on line 7a of the Form 55002022-01-01128
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 participants2022-01-01128
Number of employers contributing to the scheme2022-01-010

Form 5500 Responses for COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC. (CLUES) WELFARE BENEFITS PLAN

2022: COMUNIDADES LATINAS UNIDAS EN SERVICIO, INC. (CLUES) WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01First time form 5500 has been submittedYes
2022-01-01Submission has been amendedYes
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

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number927860
Policy instance 1
Insurance contract or identification number927860
Number of Individuals Covered128
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $10,670
Total amount of fees paid to insurance companyUSD $2,963
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $89,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,670
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number152998
Policy instance 2
Insurance contract or identification number152998
Number of Individuals Covered25
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $582
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $2,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $503
Amount paid for insurance broker fees0
Insurance broker organization code?4
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number152998
Policy instance 2
Insurance contract or identification number152998
Number of Individuals Covered128
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
Other welfare benefits providedLEGAL
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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