401k Plan data: MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN plan

MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN 401k Plan overview

Plan Name	MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN
Plan identification number	501

MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN Benefits

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

401k Sponsoring company profile

MIDWEST SCRAP MANAGEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name: MIDWEST SCRAP MANAGEMENT, INC.

Employer identification number (EIN): 431527722

NAIC Classification: 562000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01

Plan Statistics for MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN

401k plan membership statisitcs for MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN

Measure Date Value
2022: MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 117
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 117

Measure	Date	Value
2022: MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	117
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	117

Form 5500 Responses for MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN

2022: MIDWEST SCRAP MANAGEMENT, INC. GROUP HEALTH PLAN 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

ARMADACARE (National Association of Insurance Commissioners NAIC id number: 66281 )

Policy contract number

SA001549

Policy instance

Insurance contract or identification number	SA001549
Number of Individuals Covered	4
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $150
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $150
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

08007A

Policy instance

Insurance contract or identification number	08007A
Number of Individuals Covered	1
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,051
Other welfare benefits provided	MBA COVERAGE
Welfare Benefit Premiums Paid to Carrier	USD $5,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,051
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00555592

Policy instance

Insurance contract or identification number	00555592
Number of Individuals Covered	117
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $10,092
Total amount of fees paid to insurance company	USD $3,441
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, ACCIDENT, VOLUNTARY CI
Welfare Benefit Premiums Paid to Carrier	USD $88,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,092
Amount paid for insurance broker fees	3441
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL33177

Policy instance

Insurance contract or identification number	HCL33177
Number of Individuals Covered	87
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Welfare Benefit Premiums Paid to Carrier	USD $289,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

161416

Policy instance

Insurance contract or identification number	161416
Number of Individuals Covered	28
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,473
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,621
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,293
Insurance broker organization code?	3

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Company Name:	MIDWEST SCRAP MANAGEMENT, INC.
Employer identification number (EIN):	431527722
NAIC Classification:	562000