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WAGGONER ENGINEERING WELFARE BENEFITS PLAN 401k Plan overview

Plan NameWAGGONER ENGINEERING WELFARE BENEFITS PLAN
Plan identification number 501

WAGGONER ENGINEERING WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

WAGGONER ENGINEERING, INC. has sponsored the creation of one or more 401k plans.

Company Name:WAGGONER ENGINEERING, INC.
Employer identification number (EIN):640591204
NAIC Classification:541330
NAIC Description:Engineering Services

Additional information about WAGGONER ENGINEERING, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2009-02-26
Company Identification Number: 0801091739
Legal Registered Office Address: 143A LEFLEURS SQ

JACKSON
United States of America (USA)
39211

More information about WAGGONER ENGINEERING, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WAGGONER ENGINEERING WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01TRACY OSBORN2023-10-13

Plan Statistics for WAGGONER ENGINEERING WELFARE BENEFITS PLAN

401k plan membership statisitcs for WAGGONER ENGINEERING WELFARE BENEFITS PLAN

Measure Date Value
2022: WAGGONER ENGINEERING WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01101
Total number of active participants reported on line 7a of the Form 55002022-01-01139
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01141
Number of employers contributing to the scheme2022-01-010

Form 5500 Responses for WAGGONER ENGINEERING WELFARE BENEFITS PLAN

2022: WAGGONER ENGINEERING WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01First time form 5500 has been submittedYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number27464
Policy instance 1
Insurance contract or identification number27464
Number of Individuals Covered214
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $26,390
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $26,390
Amount paid for insurance broker fees0
Insurance broker organization code?3
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number3212
Policy instance 2
Insurance contract or identification number3212
Number of Individuals Covered136
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $19,285
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $200,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $19,285
Amount paid for insurance broker fees0
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number760056
Policy instance 3
Insurance contract or identification number760056
Number of Individuals Covered102
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,572
Total amount of fees paid to insurance companyUSD $173
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $59,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,572
Amount paid for insurance broker fees173
Additional information about fees paid to insurance brokerCONTINGENT COMMISSION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BGZS
Policy instance 4
Insurance contract or identification numberGLUG0BGZS
Number of Individuals Covered140
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $14,412
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $99,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,412
Amount paid for insurance broker fees0
Insurance broker organization code?3

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