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| Plan Name | KOLB ELECTRIC, INC. HEALTH AND WELFARE BENEFIT PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | KOLB ELECTRIC, INC. |
| Employer identification number (EIN): | 530232982 |
| NAIC Classification: | 238210 |
| NAIC Description: | Electrical Contractors and Other Wiring Installation Contractors |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2018-05-01 | PAUL MALCOLM KOLB | 2019-09-26 |
| Measure | Date | Value |
|---|---|---|
| 2018: KOLB ELECTRIC, INC. HEALTH AND WELFARE BENEFIT PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-05-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 96 |
| Number of retired or separated participants receiving benefits | 2018-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-05-01 | 0 |
| Total of all active and inactive participants | 2018-05-01 | 96 |
| 2018: KOLB ELECTRIC, INC. HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-05-01 | Type of plan entity | Single employer plan |
| 2018-05-01 | First time form 5500 has been submitted | Yes |
| 2018-05-01 | Submission has been amended | No |
| 2018-05-01 | This submission is the final filing | No |
| 2018-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-05-01 | Plan is a collectively bargained plan | No |
| 2018-05-01 | Plan funding arrangement – Insurance | Yes |
| 2018-05-01 | Plan benefit arrangement – Insurance | Yes |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10229386 00000 |
| Policy instance | 1 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 9S77204 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 1D034528 000000 |
| Policy instance | 3 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | CSG98 |
| Policy instance | 4 |
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