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CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 401k Plan overview

Plan NameCALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN
Plan identification number 502

CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Vision

401k Sponsoring company profile

CALDWELL MANUFACTURING COMPANY, N.A., LLC has sponsored the creation of one or more 401k plans.

Company Name:CALDWELL MANUFACTURING COMPANY, N.A., LLC
Employer identification number (EIN):800517021
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022016-01-01ROBERT LELIO
5022016-01-01
5022015-01-01ROBERT LELIO
5022014-01-01ROBERT LELIO
5022013-01-01ROBERT LELIO
5022012-01-01ROBERT LELIO

Plan Statistics for CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN

401k plan membership statisitcs for CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN

Measure Date Value
2016: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01177
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Total participants2016-01-010
2015: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01175
Total number of active participants reported on line 7a of the Form 55002015-01-01140
Number of retired or separated participants receiving benefits2015-01-0122
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01162
Total participants2015-01-01162
2014: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01139
Total number of active participants reported on line 7a of the Form 55002014-01-01139
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01139
Total participants2014-01-01139
2013: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01147
Total number of active participants reported on line 7a of the Form 55002013-01-01137
Number of retired or separated participants receiving benefits2013-01-0125
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01162
Total participants2013-01-01162
2012: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01134
Total number of active participants reported on line 7a of the Form 55002012-01-01121
Number of retired or separated participants receiving benefits2012-01-0128
Total of all active and inactive participants2012-01-01149
Total participants2012-01-01149

Form 5500 Responses for CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN

2016: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
2016-01-01This submission is the final filingYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: CALDWELL MANUFACTURING COMPANY, N.A., LLC HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00510508
Policy instance 5
Insurance contract or identification number00510508
Number of Individuals Covered15
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00500239
Policy instance 4
Insurance contract or identification number00500239
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 )
Policy contract number700679
Policy instance 3
Insurance contract or identification number700679
Number of Individuals Covered8
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $600
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $600
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number9814195
Policy instance 2
Insurance contract or identification number9814195
Number of Individuals Covered181
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,239
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,239
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00017061
Policy instance 1
Insurance contract or identification number00017061
Number of Individuals Covered146
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $50,082
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,082
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 )
Policy contract number700679
Policy instance 3
Insurance contract or identification number700679
Number of Individuals Covered9
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,500
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,500
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number9814195
Policy instance 2
Insurance contract or identification number9814195
Number of Individuals Covered185
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00017061
Policy instance 1
Insurance contract or identification number00017061
Number of Individuals Covered150
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $50,808
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,808
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 )
Policy contract number700679
Policy instance 3
Insurance contract or identification number700679
Number of Individuals Covered9
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,600
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,000
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number9814195
Policy instance 2
Insurance contract or identification number9814195
Number of Individuals Covered149
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $478
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $478
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00017061
Policy instance 1
Insurance contract or identification number00017061
Number of Individuals Covered134
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $53,387
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,355
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number9814195
Policy instance 3
Insurance contract or identification number9814195
Number of Individuals Covered127
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $394
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $394
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00017061
Policy instance 2
Insurance contract or identification number00017061
Number of Individuals Covered118
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $45,712
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,712
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 )
Policy contract number700679
Policy instance 1
Insurance contract or identification number700679
Number of Individuals Covered9
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,250
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,250
Insurance broker organization code?3
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Amount paid for insurance broker fees0
Insurance broker nameMERCER HEALTH & BENEFITS

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