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XSSENTIALS LLC 401(K) PLAN 401k Plan overview

Plan NameXSSENTIALS LLC 401(K) PLAN
Plan identification number 001

XSSENTIALS LLC 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

XSSENTIALS LLC has sponsored the creation of one or more 401k plans.

Company Name:XSSENTIALS LLC
Employer identification number (EIN):461297298
NAIC Classification:238900

Additional information about XSSENTIALS LLC

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 2012-10-31
Company Identification Number: 20121607836
Legal Registered Office Address: 109 Aspen Airport Business Ctr

Aspen
United States of America (USA)
81611

More information about XSSENTIALS LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan XSSENTIALS LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01DAVID STYS2024-09-17
0012022-01-01
0012022-01-01DAVID STYS
0012021-01-01
0012021-01-01DAVID STYS
0012020-01-01
0012019-04-01

Financial Data on XSSENTIALS LLC 401(K) PLAN

Measure Date Value
2025 : XSSENTIALS LLC 401(K) PLAN 2025 401k financial data
Total expenses incurred by plan in this plan year2025-08-26150640
Net assets as of the end of the plan year2025-08-263684012
Total assets as of the beginning of the plan year2025-08-262944348
Value of plan covered by a fidelity bond2025-08-261000000
Participant contributions to plan in this plan year2025-08-26395431
Value of participant loans at end of plan year2025-08-2641480
Other income to plan in this plan year2025-08-26458293
Plan net income in this plan year2025-08-26739664
Net assets as of the end of the plan year2025-08-263684012
Net assets as of the beginning of the plan year2025-08-262944348
Employer contributions to plan in this plan year2025-08-2636580
Expensese paid to adminstrative service provicers from plan in this plan year2025-08-2617635
2024 : XSSENTIALS LLC 401(K) PLAN 2024 401k financial data
Total expenses incurred by plan in this plan year2024-09-17277721
Net assets as of the end of the plan year2024-09-172944348
Total assets as of the beginning of the plan year2024-09-172489909
Value of plan covered by a fidelity bond2024-09-171000000
Participant contributions to plan in this plan year2024-09-17276343
Value of participant loans at end of plan year2024-09-1761293
Other contributions to plan in this plan year2024-09-173270
Other income to plan in this plan year2024-09-17417511
Plan net income in this plan year2024-09-17454439
Net assets as of the end of the plan year2024-09-172944348
Net assets as of the beginning of the plan year2024-09-172489909
Employer contributions to plan in this plan year2024-09-1735036
Expensese paid to adminstrative service provicers from plan in this plan year2024-09-1711032
2022 : XSSENTIALS LLC 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-351,427
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$495,082
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$463,175
Expenses. Certain deemed distributions of participant loans2022-12-31$5,539
Value of total corrective distributions2022-12-31$23,368
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$254,392
Value of total assets at end of year2022-12-31$2,489,909
Value of total assets at beginning of year2022-12-31$3,336,418
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$3,000
Total interest from all sources2022-12-31$1,423
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$228,324
Participant contributions at end of year2022-12-31$31,331
Participant contributions at beginning of year2022-12-31$20,855
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-846,509
Value of net assets at end of year (total assets less liabilities)2022-12-31$2,489,909
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$3,336,418
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$2,446,904
Value of interest in pooled separate accounts at beginning of year2022-12-31$3,253,111
Interest on participant loans2022-12-31$1,393
Interest earned on other investments2022-12-31$30
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$11,674
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$62,452
Net investment gain/loss from pooled separate accounts2022-12-31$-607,242
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$26,068
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$463,175
Contract administrator fees2022-12-31$3,000
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31REESE HENRY AND COMPANY, INC.
Accountancy firm EIN2022-12-31840803727
Total unrealized appreciation/depreciation of assets2022-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total income from all sources (including contributions)2022-01-01$-351,427
Total loss/gain on sale of assets2022-01-01$0
Total of all expenses incurred2022-01-01$495,082
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$463,175
Expenses. Certain deemed distributions of participant loans2022-01-01$5,539
Value of total corrective distributions2022-01-01$23,368
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$254,392
Value of total assets at end of year2022-01-01$2,489,909
Value of total assets at beginning of year2022-01-01$3,336,418
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$3,000
Total interest from all sources2022-01-01$1,423
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$0
Was this plan covered by a fidelity bond2022-01-01Yes
Value of fidelity bond cover2022-01-01$1,000,000
If this is an individual account plan, was there a blackout period2022-01-01No
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Contributions received from participants2022-01-01$228,324
Participant contributions at end of year2022-01-01$31,331
Participant contributions at beginning of year2022-01-01$20,855
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Value of net income/loss2022-01-01$-846,509
Value of net assets at end of year (total assets less liabilities)2022-01-01$2,489,909
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$3,336,418
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Value of interest in pooled separate accounts at end of year2022-01-01$2,446,904
Value of interest in pooled separate accounts at beginning of year2022-01-01$3,253,111
Interest on participant loans2022-01-01$1,393
Interest earned on other investments2022-01-01$30
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-01-01$11,674
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-01-01$62,452
Net investment gain/loss from pooled separate accounts2022-01-01$-607,242
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01No
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Contributions received in cash from employer2022-01-01$26,068
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-01$463,175
Contract administrator fees2022-01-01$3,000
Did the plan have assets held for investment2022-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01No
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01REESE HENRY AND COMPANY, INC.
Accountancy firm EIN2022-01-01840803727
2021 : XSSENTIALS LLC 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$790,394
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$121,183
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$120,353
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$400,304
Value of total assets at end of year2021-12-31$3,336,418
Value of total assets at beginning of year2021-12-31$2,667,207
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$830
Total interest from all sources2021-12-31$1,889
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$342,302
Participant contributions at end of year2021-12-31$20,855
Participant contributions at beginning of year2021-12-31$27,821
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$669,211
Value of net assets at end of year (total assets less liabilities)2021-12-31$3,336,418
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,667,207
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$3,253,111
Value of interest in pooled separate accounts at beginning of year2021-12-31$2,577,465
Interest on participant loans2021-12-31$1,269
Interest earned on other investments2021-12-31$620
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$62,452
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$61,921
Net investment gain/loss from pooled separate accounts2021-12-31$388,201
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$58,002
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$120,353
Contract administrator fees2021-12-31$830
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31REESE HENRY AND COMPANY, INC.
Accountancy firm EIN2021-12-31840803727
2020 : XSSENTIALS LLC 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$612,755
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$277,482
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$245,005
Value of total corrective distributions2020-12-31$31,122
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$280,416
Value of total assets at end of year2020-12-31$2,667,207
Value of total assets at beginning of year2020-12-31$2,331,934
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,355
Total interest from all sources2020-12-31$4,171
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$235,458
Participant contributions at end of year2020-12-31$27,821
Participant contributions at beginning of year2020-12-31$59,241
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$103
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$335,273
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,667,207
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,331,934
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$2,577,465
Value of interest in pooled separate accounts at beginning of year2020-12-31$2,251,081
Interest on participant loans2020-12-31$3,618
Interest earned on other investments2020-12-31$553
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$61,921
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$21,612
Net investment gain/loss from pooled separate accounts2020-12-31$328,168
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$44,855
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$245,005
Contract administrator fees2020-12-31$1,355
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31REESE HENRY AND COMPANY, INC.
Accountancy firm EIN2020-12-31840803727
2019 : XSSENTIALS LLC 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets to this plan2019-12-31$1,934,742
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$410,953
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$13,761
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$13,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$198,337
Value of total assets at end of year2019-12-31$2,331,934
Value of total assets at beginning of year2019-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$625
Total interest from all sources2019-12-31$2,249
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$164,751
Participant contributions at end of year2019-12-31$59,241
Participant contributions at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$28
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$397,192
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,331,934
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$2,251,081
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Interest on participant loans2019-12-31$2,090
Interest earned on other investments2019-12-31$159
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$21,612
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$210,367
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$33,558
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$13,136
Contract administrator fees2019-12-31$625
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31REESE HENRY AND COMPANY, INC.
Accountancy firm EIN2019-12-31840803727

Form 5500 Responses for XSSENTIALS LLC 401(K) PLAN

2022: XSSENTIALS LLC 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: XSSENTIALS LLC 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: XSSENTIALS LLC 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: XSSENTIALS LLC 401(K) PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01First time form 5500 has been submittedYes
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81C819
Policy instance 1
Insurance contract or identification number81C819
Number of Individuals Covered54
Insurance policy start date2022-04-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $16,456
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81C819
Policy instance 1
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81C819
Policy instance 1
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81C819
Policy instance 1

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