401k Plan data: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN plan

COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 401k Plan overview

Plan Name	COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN
Plan identification number	507

COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

COSMETIC LABORATORIES OF AMERICA, LLC has sponsored the creation of one or more 401k plans.

Company Name: COSMETIC LABORATORIES OF AMERICA, LLC

Employer identification number (EIN): 453790506

NAIC Classification: 424990
NAIC Description: Other Miscellaneous Nondurable Goods Merchant Wholesalers

Additional information about COSMETIC LABORATORIES OF AMERICA, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 5063314

More information about COSMETIC LABORATORIES OF AMERICA, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
507 2016-01-01 TRISHA L GIANESIN
507 2016-01-01 DORIANN CULLOTTA 2018-11-12
507 2015-01-01 CINDY LANGE
507 2014-01-01 CINDY LANGE CINDY LANGE 2015-07-15
507 2013-01-01 CINDY LANGE CINDY LANGE 2014-07-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
507	2016-01-01	TRISHA L GIANESIN
507	2016-01-01	DORIANN CULLOTTA	2018-11-12
507	2015-01-01	CINDY LANGE
507	2014-01-01	CINDY LANGE		CINDY LANGE	2015-07-15
507	2013-01-01	CINDY LANGE		CINDY LANGE	2014-07-25

Plan Statistics for COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN

401k plan membership statisitcs for COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN

Measure Date Value
2016: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 170
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 170
2015: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 170
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 170
2014: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 178
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 173
Total of all active and inactive participants 2014-01-01 173
2013: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 174
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 175
Total of all active and inactive participants 2013-01-01 175

Measure	Date	Value
2016: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	170
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	170
2015: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	170
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	170
2014: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	178
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	173
Total of all active and inactive participants	2014-01-01	173
2013: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	175
Total of all active and inactive participants	2013-01-01	175

Form 5500 Responses for COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN

2016: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: COSMETIC LABORATORIES OF AMERICA, LLC LIFE & DISABILITY PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

226156

Policy instance

Insurance contract or identification number	226156
Number of Individuals Covered	170
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,679
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 Carrier	USD $66,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,679
Insurance broker organization code?	3
Insurance broker name	H GROUP BENEFITS, INC.

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

226156

Policy instance

Insurance contract or identification number	226156
Number of Individuals Covered	173
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,541
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	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $64,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,541
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	H GROUP BENEFITS, INC.

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

226156

Policy instance

Insurance contract or identification number	226156
Number of Individuals Covered	175
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,334
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	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $56,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,334
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	H GROUP BENEFITS, INC.

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Company Name:	COSMETIC LABORATORIES OF AMERICA, LLC
Employer identification number (EIN):	453790506
NAIC Classification:	424990
NAIC Description:	Other Miscellaneous Nondurable Goods Merchant Wholesalers

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	5063314