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MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 401k Plan overview

Plan NameMEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD
Plan identification number 501

MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD Benefits

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

401k Sponsoring company profile

A-GAS US INC. has sponsored the creation of one or more 401k plans.

Company Name:A-GAS US INC.
Employer identification number (EIN):460635641
NAIC Classification:424600

Additional information about A-GAS US INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2018-12-14
Company Identification Number: 0803187757
Legal Registered Office Address: 1100 HASKINS RD

BOWLING GREEN
United States of America (USA)
43402

More information about A-GAS US INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01KERRY WOLFF2023-06-28
5012021-01-01KERRY WOLFF2022-09-19
5012020-01-01KERRY WOLFF2021-05-05
5012019-01-01KERRY WOLFF2020-06-04
5012018-01-01ANGELA FORD2019-08-08

Plan Statistics for MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD

401k plan membership statisitcs for MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD

Measure Date Value
2022: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2022 401k membership
Total participants, beginning-of-year2022-01-01243
Total number of active participants reported on line 7a of the Form 55002022-01-01355
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 participants2022-01-01355
Number of employers contributing to the scheme2022-01-010
2021: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2021 401k membership
Total participants, beginning-of-year2021-01-01204
Total number of active participants reported on line 7a of the Form 55002021-01-01243
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01243
Number of employers contributing to the scheme2021-01-010
2020: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2020 401k membership
Total participants, beginning-of-year2020-01-01239
Total number of active participants reported on line 7a of the Form 55002020-01-01235
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01235
Number of employers contributing to the scheme2020-01-010
2019: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2019 401k membership
Total participants, beginning-of-year2019-01-01285
Total number of active participants reported on line 7a of the Form 55002019-01-01239
Number of retired or separated participants receiving benefits2019-01-016
Number of other retired or separated participants entitled to future benefits2019-01-0122
Total of all active and inactive participants2019-01-01267
Number of employers contributing to the scheme2019-01-010
2018: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2018 401k membership
Total participants, beginning-of-year2018-01-01139
Total number of active participants reported on line 7a of the Form 55002018-01-01146
Number of retired or separated participants receiving benefits2018-01-018
Number of other retired or separated participants entitled to future benefits2018-01-014
Total of all active and inactive participants2018-01-01158
Number of employers contributing to the scheme2018-01-010

Form 5500 Responses for MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD

2022: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
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
2021: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: MEDICAL, DENTAL, VISION, LIFE AD&D, VOL LIFE, LTD, STD 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number942219
Policy instance 1
Insurance contract or identification number942219
Number of Individuals Covered355
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $37,205
Total amount of fees paid to insurance companyUSD $23,085
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 providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $388,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,205
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number942219
Policy instance 1
Insurance contract or identification number942219
Number of Individuals Covered280
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $26,170
Total amount of fees paid to insurance companyUSD $14,142
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 providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $272,295
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,787
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1103284
Policy instance 1
Insurance contract or identification number1103284
Number of Individuals Covered453
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $26,500
Total amount of fees paid to insurance companyUSD $12,944
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 providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $258,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,381
Amount paid for insurance broker fees12944
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number913963
Policy instance 1
Insurance contract or identification number913963
Number of Individuals Covered224
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $3
Total amount of fees paid to insurance companyUSD $83,642
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,098,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3
Amount paid for insurance broker fees55952
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1103284
Policy instance 2
Insurance contract or identification number1103284
Number of Individuals Covered467
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $28,310
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $339,290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,520
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number913963
Policy instance 1
Insurance contract or identification number913963
Number of Individuals Covered313
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,890
Total amount of fees paid to insurance companyUSD $72,408
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,890
Amount paid for insurance broker fees72408
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number303822
Policy instance 2
Insurance contract or identification number303822
Number of Individuals Covered143
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $11,387
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $103,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,387
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number303822
Policy instance 3
Insurance contract or identification number303822
Number of Individuals Covered146
Insurance policy start date2018-12-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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