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SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN 401k Plan overview

Plan NameSHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN
Plan identification number 502

SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

SHALOM BARANES ASSOCIATES, PC has sponsored the creation of one or more 401k plans.

Company Name:SHALOM BARANES ASSOCIATES, PC
Employer identification number (EIN):521845924
NAIC Classification:541310
NAIC Description:Architectural Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022018-09-01PAMELA GREEN2020-03-18
5022017-09-01DEBRA BAUGH2019-03-28
5022016-09-01

Plan Statistics for SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN

401k plan membership statisitcs for SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN

Measure Date Value
2018: SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01103
Total number of active participants reported on line 7a of the Form 55002018-09-0190
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-0190
Number of employers contributing to the scheme2018-09-010
2017: SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01103
Total number of active participants reported on line 7a of the Form 55002017-09-01103
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01103
Number of employers contributing to the scheme2017-09-010
2016: SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01108
Total number of active participants reported on line 7a of the Form 55002016-09-01108
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01108

Form 5500 Responses for SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN

2018: SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: SHALOM BARANES ASSOCIATES, P.C. LIFE AND DISABILITY PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01First time form 5500 has been submittedYes
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number341643G
Policy instance 1
Insurance contract or identification number341643G
Number of Individuals Covered90
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $14,334
Total amount of fees paid to insurance companyUSD $1,195
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 $95,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,334
Amount paid for insurance broker fees1195
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number341643G
Policy instance 1
Insurance contract or identification number341643G
Number of Individuals Covered108
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $15,100
Total amount of fees paid to insurance companyUSD $679
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 $100,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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