401k Plan data: OUTOTEC USA INC HEALTH PLAN plan

OUTOTEC USA INC HEALTH PLAN 401k Plan overview

Plan Name	OUTOTEC USA INC HEALTH PLAN
Plan identification number	501

OUTOTEC USA INC HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

OUTOTEC USA INC. has sponsored the creation of one or more 401k plans.

Company Name: OUTOTEC USA INC.

Employer identification number (EIN): 521659765

NAIC Classification: 339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OUTOTEC USA INC HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-07-01
501 2015-07-01
501 2014-07-01 ANNA TOIVA
501 2013-07-01 STEPHANIE FANG STEPHANIE FANG 2015-03-05
501 2012-07-01 STEPHANIE FANG

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2015-07-01
501	2015-07-01
501	2014-07-01	ANNA TOIVA
501	2013-07-01	STEPHANIE FANG	STEPHANIE FANG	2015-03-05
501	2012-07-01	STEPHANIE FANG

Plan Statistics for OUTOTEC USA INC HEALTH PLAN

401k plan membership statisitcs for OUTOTEC USA INC HEALTH PLAN

Measure Date Value
2015: OUTOTEC USA INC HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 132
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 0
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 0
2014: OUTOTEC USA INC HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 142
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 130
Number of retired or separated participants receiving benefits 2014-07-01 2
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 132
2013: OUTOTEC USA INC HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 135
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 138
Number of retired or separated participants receiving benefits 2013-07-01 4
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 142
2012: OUTOTEC USA INC HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 117
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 129
Number of retired or separated participants receiving benefits 2012-07-01 6
Number of other retired or separated participants entitled to future benefits 2012-07-01 0
Total of all active and inactive participants 2012-07-01 135

Measure	Date	Value
2015: OUTOTEC USA INC HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	132
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	0
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	0
2014: OUTOTEC USA INC HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	142
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	130
Number of retired or separated participants receiving benefits	2014-07-01	2
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	132
2013: OUTOTEC USA INC HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	135
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	138
Number of retired or separated participants receiving benefits	2013-07-01	4
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	142
2012: OUTOTEC USA INC HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	117
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	129
Number of retired or separated participants receiving benefits	2012-07-01	6
Number of other retired or separated participants entitled to future benefits	2012-07-01	0
Total of all active and inactive participants	2012-07-01	135

Form 5500 Responses for OUTOTEC USA INC HEALTH PLAN

2015: OUTOTEC USA INC HEALTH PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	Yes
2015-07-01	This submission is the final filing	Yes
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: OUTOTEC USA INC HEALTH PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: OUTOTEC USA INC HEALTH PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: OUTOTEC USA INC HEALTH PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	First time form 5500 has been submitted	Yes
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )

Policy contract number

1K0X

Policy instance

Insurance contract or identification number	1K0X
Number of Individuals Covered	130
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $74,991
Total amount of fees paid to insurance company	USD $10,711
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	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $1,499,821
Commission paid to Insurance Broker	USD $74,991
Amount paid for insurance broker fees	10711
Additional information about fees paid to insurance broker	MEDICAL CONTRACTS PCPM NON-MONETARY INCENTIVE
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INS GROUP

CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )

Policy contract number

1K0X

Policy instance

Insurance contract or identification number	1K0X
Number of Individuals Covered	130
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $69,980
Total amount of fees paid to insurance company	USD $13,439
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	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $1,399,603
Commission paid to Insurance Broker	USD $69,980
Amount paid for insurance broker fees	13439
Additional information about fees paid to insurance broker	MEDICAL CONTRACTS PCPM DENTAL CONTRACTS PCPM NON-MONETARY INCENTIVE
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INS GROUP

CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )

Policy contract number

1K0X

Policy instance

Insurance contract or identification number	1K0X
Number of Individuals Covered	138
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $54,553
Total amount of fees paid to insurance company	USD $13,013
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	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $1,558,672
Commission paid to Insurance Broker	USD $54,553
Amount paid for insurance broker fees	13013
Additional information about fees paid to insurance broker	MEDICAL/DENTAL CONTRACTS PCPM NEW BUSINESS BONUS NON-MONETARY INCENTIVE
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INS GROUP

CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )

Policy contract number

1K0X

Policy instance

Insurance contract or identification number	1K0X
Number of Individuals Covered	129
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $44,881
Total amount of fees paid to insurance company	USD $14,664
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	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $1,282,319
Commission paid to Insurance Broker	USD $44,881
Amount paid for insurance broker fees	14664
Additional information about fees paid to insurance broker	MEDICAL/DENTAL CONTRACTS PCPM NEW BUSINESS BONUS NON-MONETARY INCENTIVE
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INS GROUP

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Company Name:	OUTOTEC USA INC.
Employer identification number (EIN):	521659765
NAIC Classification:	339900