401k Plan data: AGSTATE COOPERATIVE HEALTH & WELFARE plan

AGSTATE COOPERATIVE HEALTH & WELFARE 401k Plan overview

Plan Name	AGSTATE COOPERATIVE HEALTH & WELFARE
Plan identification number	501

AGSTATE COOPERATIVE HEALTH & WELFARE Benefits

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

401k Sponsoring company profile

FIRST COOPERATIVE ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name: FIRST COOPERATIVE ASSOCIATION

Employer identification number (EIN): 420243900

NAIC Classification: 115110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AGSTATE COOPERATIVE HEALTH & WELFARE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 ELISSA BARRICK 2023-07-05 ELISSA BARRICK 2023-07-05

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	ELISSA BARRICK	2023-07-05	ELISSA BARRICK	2023-07-05

Plan Statistics for AGSTATE COOPERATIVE HEALTH & WELFARE

401k plan membership statisitcs for AGSTATE COOPERATIVE HEALTH & WELFARE

Measure Date Value
2022: AGSTATE COOPERATIVE HEALTH & WELFARE 2022 401k membership
Total participants, beginning-of-year 2022-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 337
Total of all active and inactive participants 2022-01-01 337

Measure	Date	Value
2022: AGSTATE COOPERATIVE HEALTH & WELFARE 2022 401k membership
Total participants, beginning-of-year	2022-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	337
Total of all active and inactive participants	2022-01-01	337

Form 5500 Responses for AGSTATE COOPERATIVE HEALTH & WELFARE

2022: AGSTATE COOPERATIVE HEALTH & WELFARE 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	First time form 5500 has been submitted	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )

Policy contract number

010-057853

Policy instance

Insurance contract or identification number	010-057853
Number of Individuals Covered	563
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,712
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $47,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,712
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

116083

Policy instance

Insurance contract or identification number	116083
Number of Individuals Covered	179
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,730
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	LONG TERM CARE
Welfare Benefit Premiums Paid to Carrier	USD $29,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,730
Insurance broker organization code?	4

WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )

Policy contract number

B93

Policy instance

Insurance contract or identification number	B93
Number of Individuals Covered	337
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $55,089
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $55,089
Insurance broker organization code?	3

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

92340

Policy instance

Insurance contract or identification number	92340
Number of Individuals Covered	76
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $3,626
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $24,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,060
Insurance broker organization code?	3

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

V4672

Policy instance

Insurance contract or identification number	V4672
Number of Individuals Covered	112
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $14,022
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $36,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,485
Insurance broker organization code?	3

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

70648-5

Policy instance

Insurance contract or identification number	70648-5
Number of Individuals Covered	438
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $32,959
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D AND CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $263,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,959
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	FIRST COOPERATIVE ASSOCIATION
Employer identification number (EIN):	420243900
NAIC Classification:	115110