401k Plan data: VISION COVERAGE plan

VISION COVERAGE 401k Plan overview

Plan Name	VISION COVERAGE
Plan identification number	505

VISION COVERAGE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Vision

401k Sponsoring company profile

KIT HOMEBUILDERS WEST, LLC has sponsored the creation of one or more 401k plans.

Company Name: KIT HOMEBUILDERS WEST, LLC

Employer identification number (EIN): 731663451

NAIC Classification: 321900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VISION COVERAGE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2022-01-01 CAROLYN L. LINDSTROM 2023-04-28 CAROLYN L. LINDSTROM 2023-04-28
505 2021-01-01 CAROLYN LINDSTROM 2022-03-22 CAROLYN LINDSTROM 2022-03-22
505 2020-01-01 CAROLYN LINDSTROM 2021-04-29 CAROLYN LINDSTROM 2021-04-29
505 2019-01-01 CAROLYN LINDSTROM 2020-04-27 CAROLYN LINDSTROM 2020-04-27
505 2018-01-01
505 2017-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
505	2022-01-01	CAROLYN L. LINDSTROM	2023-04-28	CAROLYN L. LINDSTROM	2023-04-28
505	2021-01-01	CAROLYN LINDSTROM	2022-03-22	CAROLYN LINDSTROM	2022-03-22
505	2020-01-01	CAROLYN LINDSTROM	2021-04-29	CAROLYN LINDSTROM	2021-04-29
505	2019-01-01	CAROLYN LINDSTROM	2020-04-27	CAROLYN LINDSTROM	2020-04-27
505	2018-01-01
505	2017-01-01

Plan Statistics for VISION COVERAGE

401k plan membership statisitcs for VISION COVERAGE

Measure Date Value
2022: VISION COVERAGE 2022 401k membership
Total participants, beginning-of-year 2022-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 130
Number of retired or separated participants receiving benefits 2022-01-01 1
Total of all active and inactive participants 2022-01-01 131
2021: VISION COVERAGE 2021 401k membership
Total participants, beginning-of-year 2021-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 144
Number of retired or separated participants receiving benefits 2021-01-01 1
Total of all active and inactive participants 2021-01-01 145
2020: VISION COVERAGE 2020 401k membership
Total participants, beginning-of-year 2020-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 142
Number of retired or separated participants receiving benefits 2020-01-01 1
Total of all active and inactive participants 2020-01-01 143
2019: VISION COVERAGE 2019 401k membership
Total participants, beginning-of-year 2019-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 155
Number of retired or separated participants receiving benefits 2019-01-01 1
Total of all active and inactive participants 2019-01-01 156
2018: VISION COVERAGE 2018 401k membership
Total participants, beginning-of-year 2018-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 133
Total of all active and inactive participants 2018-01-01 133
2017: VISION COVERAGE 2017 401k membership
Total participants, beginning-of-year 2017-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 103
Total of all active and inactive participants 2017-01-01 103

Measure	Date	Value
2022: VISION COVERAGE 2022 401k membership
Total participants, beginning-of-year	2022-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	130
Number of retired or separated participants receiving benefits	2022-01-01	1
Total of all active and inactive participants	2022-01-01	131
2021: VISION COVERAGE 2021 401k membership
Total participants, beginning-of-year	2021-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	144
Number of retired or separated participants receiving benefits	2021-01-01	1
Total of all active and inactive participants	2021-01-01	145
2020: VISION COVERAGE 2020 401k membership
Total participants, beginning-of-year	2020-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	142
Number of retired or separated participants receiving benefits	2020-01-01	1
Total of all active and inactive participants	2020-01-01	143
2019: VISION COVERAGE 2019 401k membership
Total participants, beginning-of-year	2019-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	155
Number of retired or separated participants receiving benefits	2019-01-01	1
Total of all active and inactive participants	2019-01-01	156
2018: VISION COVERAGE 2018 401k membership
Total participants, beginning-of-year	2018-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	133
Total of all active and inactive participants	2018-01-01	133
2017: VISION COVERAGE 2017 401k membership
Total participants, beginning-of-year	2017-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	103
Total of all active and inactive participants	2017-01-01	103

Form 5500 Responses for VISION COVERAGE

2022: VISION COVERAGE 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: VISION COVERAGE 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: VISION COVERAGE 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: VISION COVERAGE 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: VISION COVERAGE 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: VISION COVERAGE 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )

Policy contract number

GV-3079

Policy instance

Insurance contract or identification number	GV-3079
Number of Individuals Covered	131
Insurance policy start date	2022-01-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $1,293
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,931
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,293
Insurance broker organization code?	3

UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )

Policy contract number

GV-3079

Policy instance

Insurance contract or identification number	GV-3079
Number of Individuals Covered	145
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,743
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,743
Insurance broker organization code?	3

UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )

Policy contract number

GV-3079

Policy instance

Insurance contract or identification number	GV-3079
Number of Individuals Covered	142
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,857
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,857
Insurance broker organization code?	3

UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )

Policy contract number

GV-3079

Policy instance

Insurance contract or identification number	GV-3079
Number of Individuals Covered	155
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,762
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,762
Insurance broker organization code?	3

UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )

Policy contract number

GV-3079

Policy instance

Insurance contract or identification number	GV-3079
Number of Individuals Covered	133
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,448
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $873
Insurance broker organization code?	3

UNITED HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63983 )

Policy contract number

GV-3079

Policy instance

Insurance contract or identification number	GV-3079
Number of Individuals Covered	103
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,353
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,353
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICES

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Company Name:	KIT HOMEBUILDERS WEST, LLC
Employer identification number (EIN):	731663451
NAIC Classification:	321900