401k Plan data: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN plan

UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 401k Plan overview

Plan Name	UNITED BRASS WORKS, INC. GROUP DENTAL PLAN
Plan identification number	507

UNITED BRASS WORKS, INC. GROUP DENTAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

UNITED BRASS WORKS, INC. has sponsored the creation of one or more 401k plans.

Company Name: UNITED BRASS WORKS, INC.

Employer identification number (EIN): 560664927

NAIC Classification: 333900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNITED BRASS WORKS, INC. GROUP DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
507 2021-12-01 ANTHONY FORMAN 2023-09-08
507 2020-12-01 ANTHONY FORMAN 2022-06-24
507 2019-12-01 ANTHONY FORMAN 2021-09-12
507 2018-12-01 ANTHONY FORMAN 2020-09-09
507 2018-11-01 ANTHONY FORMAN 2020-09-09
507 2017-11-01 ANTHONY FORMAN 2019-05-28
507 2016-11-01
507 2015-11-01
507 2014-11-01
507 2009-05-01 NATASHA TROGDON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
507	2021-12-01	ANTHONY FORMAN	2023-09-08
507	2020-12-01	ANTHONY FORMAN	2022-06-24
507	2019-12-01	ANTHONY FORMAN	2021-09-12
507	2018-12-01	ANTHONY FORMAN	2020-09-09
507	2018-11-01	ANTHONY FORMAN	2020-09-09
507	2017-11-01	ANTHONY FORMAN	2019-05-28
507	2016-11-01
507	2015-11-01
507	2014-11-01
507	2009-05-01	NATASHA TROGDON

Plan Statistics for UNITED BRASS WORKS, INC. GROUP DENTAL PLAN

401k plan membership statisitcs for UNITED BRASS WORKS, INC. GROUP DENTAL PLAN

Measure Date Value
2021: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year 2021-12-01 130
Total number of active participants reported on line 7a of the Form 5500 2021-12-01 0
Total of all active and inactive participants 2021-12-01 0
2020: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year 2020-12-01 127
Total number of active participants reported on line 7a of the Form 5500 2020-12-01 130
Total of all active and inactive participants 2020-12-01 130
2019: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year 2019-12-01 143
Total number of active participants reported on line 7a of the Form 5500 2019-12-01 127
Total of all active and inactive participants 2019-12-01 127
2018: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year 2018-12-01 134
Total number of active participants reported on line 7a of the Form 5500 2018-12-01 143
Number of retired or separated participants receiving benefits 2018-12-01 0
Total of all active and inactive participants 2018-12-01 143
Total participants, beginning-of-year 2018-11-01 132
Total number of active participants reported on line 7a of the Form 5500 2018-11-01 134
Number of retired or separated participants receiving benefits 2018-11-01 0
Total of all active and inactive participants 2018-11-01 134
2017: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year 2017-11-01 116
Total number of active participants reported on line 7a of the Form 5500 2017-11-01 132
Total of all active and inactive participants 2017-11-01 132
2016: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-11-01 115
Total number of active participants reported on line 7a of the Form 5500 2016-11-01 115
Number of retired or separated participants receiving benefits 2016-11-01 1
Total of all active and inactive participants 2016-11-01 116
2015: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-11-01 118
Total number of active participants reported on line 7a of the Form 5500 2015-11-01 114
Number of retired or separated participants receiving benefits 2015-11-01 1
Total of all active and inactive participants 2015-11-01 115
2014: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-11-01 115
Total number of active participants reported on line 7a of the Form 5500 2014-11-01 118
Total of all active and inactive participants 2014-11-01 118
2009: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-05-01 117
Total number of active participants reported on line 7a of the Form 5500 2009-05-01 107
Total of all active and inactive participants 2009-05-01 107
Total participants 2009-05-01 107

Measure	Date	Value
2021: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year	2021-12-01	130
Total number of active participants reported on line 7a of the Form 5500	2021-12-01	0
Total of all active and inactive participants	2021-12-01	0
2020: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year	2020-12-01	127
Total number of active participants reported on line 7a of the Form 5500	2020-12-01	130
Total of all active and inactive participants	2020-12-01	130
2019: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year	2019-12-01	143
Total number of active participants reported on line 7a of the Form 5500	2019-12-01	127
Total of all active and inactive participants	2019-12-01	127
2018: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year	2018-12-01	134
Total number of active participants reported on line 7a of the Form 5500	2018-12-01	143
Number of retired or separated participants receiving benefits	2018-12-01	0
Total of all active and inactive participants	2018-12-01	143
Total participants, beginning-of-year	2018-11-01	132
Total number of active participants reported on line 7a of the Form 5500	2018-11-01	134
Number of retired or separated participants receiving benefits	2018-11-01	0
Total of all active and inactive participants	2018-11-01	134
2017: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-11-01	116
Total number of active participants reported on line 7a of the Form 5500	2017-11-01	132
Total of all active and inactive participants	2017-11-01	132
2016: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-11-01	115
Total number of active participants reported on line 7a of the Form 5500	2016-11-01	115
Number of retired or separated participants receiving benefits	2016-11-01	1
Total of all active and inactive participants	2016-11-01	116
2015: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-11-01	118
Total number of active participants reported on line 7a of the Form 5500	2015-11-01	114
Number of retired or separated participants receiving benefits	2015-11-01	1
Total of all active and inactive participants	2015-11-01	115
2014: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-11-01	115
Total number of active participants reported on line 7a of the Form 5500	2014-11-01	118
Total of all active and inactive participants	2014-11-01	118
2009: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-05-01	117
Total number of active participants reported on line 7a of the Form 5500	2009-05-01	107
Total of all active and inactive participants	2009-05-01	107
Total participants	2009-05-01	107

Form 5500 Responses for UNITED BRASS WORKS, INC. GROUP DENTAL PLAN

2021: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2021 form 5500 responses
2021-12-01	Type of plan entity	Single employer plan
2021-12-01	This submission is the final filing	Yes
2021-12-01	Plan funding arrangement – Insurance	Yes
2021-12-01	Plan benefit arrangement – Insurance	Yes
2020: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2020 form 5500 responses
2020-12-01	Type of plan entity	Single employer plan
2020-12-01	Plan funding arrangement – Insurance	Yes
2020-12-01	Plan benefit arrangement – Insurance	Yes
2019: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2019 form 5500 responses
2019-12-01	Type of plan entity	Single employer plan
2019-12-01	Plan funding arrangement – Insurance	Yes
2019-12-01	Plan benefit arrangement – Insurance	Yes
2018: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2018 form 5500 responses
2018-12-01	Type of plan entity	Single employer plan
2018-12-01	Plan funding arrangement – Insurance	Yes
2018-12-01	Plan benefit arrangement – Insurance	Yes
2018-11-01	Type of plan entity	Single employer plan
2018-11-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2018-11-01	Plan funding arrangement – Insurance	Yes
2018-11-01	Plan benefit arrangement – Insurance	Yes
2017: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2017 form 5500 responses
2017-11-01	Type of plan entity	Single employer plan
2017-11-01	Plan funding arrangement – Insurance	Yes
2017-11-01	Plan benefit arrangement – Insurance	Yes
2016: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2016 form 5500 responses
2016-11-01	Type of plan entity	Single employer plan
2016-11-01	Plan funding arrangement – Insurance	Yes
2016-11-01	Plan benefit arrangement – Insurance	Yes
2015: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2015 form 5500 responses
2015-11-01	Type of plan entity	Single employer plan
2015-11-01	Plan funding arrangement – Insurance	Yes
2015-11-01	Plan benefit arrangement – Insurance	Yes
2014: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2014 form 5500 responses
2014-11-01	Type of plan entity	Single employer plan
2014-11-01	Plan funding arrangement – Insurance	Yes
2014-11-01	Plan benefit arrangement – Insurance	Yes
2009: UNITED BRASS WORKS, INC. GROUP DENTAL PLAN 2009 form 5500 responses
2009-05-01	Type of plan entity	Single employer plan
2009-05-01	Submission has been amended	No
2009-05-01	This submission is the final filing	No
2009-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-05-01	Plan is a collectively bargained plan	No
2009-05-01	Plan funding arrangement – Insurance	Yes
2009-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54658 )

Policy contract number

10020

Policy instance

Insurance contract or identification number	10020
Number of Individuals Covered	183
Insurance policy start date	2021-12-01
Insurance policy end date	2022-11-30
Total amount of commissions paid to insurance broker	USD $7,444
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,942
Insurance broker organization code?	3

DELTA DENTAL OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54658 )

Policy contract number

10020

Policy instance

Insurance contract or identification number	10020
Number of Individuals Covered	193
Insurance policy start date	2020-12-01
Insurance policy end date	2021-11-30
Total amount of commissions paid to insurance broker	USD $7,549
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,868
Insurance broker organization code?	3

DELTA DENTAL OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54658 )

Policy contract number

10020

Policy instance

Insurance contract or identification number	10020
Number of Individuals Covered	186
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $7,314
Total amount of fees paid to insurance company	USD $1,500
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5487059

Policy instance

Insurance contract or identification number	5487059
Number of Individuals Covered	145
Insurance policy start date	2018-12-01
Insurance policy end date	2019-11-30
Total amount of commissions paid to insurance broker	USD $6,858
Total amount of fees paid to insurance company	USD $3,838
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $68,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,858
Insurance broker organization code?	3
Amount paid for insurance broker fees	2466
Additional information about fees paid to insurance broker	BONUS COMMISSIONS

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5487059

Policy instance

Insurance contract or identification number	5487059
Number of Individuals Covered	133
Insurance policy start date	2018-11-01
Insurance policy end date	2018-11-30
Total amount of commissions paid to insurance broker	USD $461
Total amount of fees paid to insurance company	USD $2,558
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $461
Amount paid for insurance broker fees	2466
Additional information about fees paid to insurance broker	BONUS COMMISSION
Insurance broker organization code?	3

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5487059

Policy instance

Insurance contract or identification number	5487059
Number of Individuals Covered	131
Insurance policy start date	2017-11-01
Insurance policy end date	2018-10-31
Total amount of commissions paid to insurance broker	USD $6,122
Total amount of fees paid to insurance company	USD $732
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $61,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

UNITED BRASS MANUFACTURERS, INC. RETIREMENT PLAN [EIN = 381349518]

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Company Name:	UNITED BRASS WORKS, INC.
Employer identification number (EIN):	560664927
NAIC Classification:	333900