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FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 401k Plan overview

Plan NameFUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN
Plan identification number 501

FUTAMURA USA, INC. EMPLOYEE HEALTH CARE 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)
  • Other welfare benefit cover

401k Sponsoring company profile

FUTAMURA USA, INC. has sponsored the creation of one or more 401k plans.

Company Name:FUTAMURA USA, INC.
Employer identification number (EIN):812619127
NAIC Classification:322200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01SARA SHAUGHNESSY
5012016-01-01SARA SHAUGHNESSY

Plan Statistics for FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN

401k plan membership statisitcs for FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN

Measure Date Value
2022: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01249
Total number of active participants reported on line 7a of the Form 55002022-01-01257
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01257
2021: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01244
Total number of active participants reported on line 7a of the Form 55002021-01-01249
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01249
2020: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01235
Total number of active participants reported on line 7a of the Form 55002020-01-01244
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01244
2019: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01237
Total number of active participants reported on line 7a of the Form 55002019-01-01235
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01235
2018: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01212
Total number of active participants reported on line 7a of the Form 55002018-01-01237
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01237
2017: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01194
Total number of active participants reported on line 7a of the Form 55002017-01-01209
Number of retired or separated participants receiving benefits2017-01-013
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01212
2016: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01192
Total number of active participants reported on line 7a of the Form 55002016-01-01192
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01194

Form 5500 Responses for FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN

2022: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: FUTAMURA USA, INC. EMPLOYEE HEALTH CARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

INTEGRATED BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number15274483
Policy instance 4
Insurance contract or identification number15274483
Number of Individuals Covered214
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $2,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00937047
Policy instance 3
Insurance contract or identification number00937047
Number of Individuals Covered5
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $56
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539296
Policy instance 2
Insurance contract or identification number00539296
Number of Individuals Covered257
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $27,253
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, ACCIDENT, VOL CI
Welfare Benefit Premiums Paid to CarrierUSD $178,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,253
Insurance broker organization code?3
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-202977
Policy instance 1
Insurance contract or identification numberUNI-202977
Number of Individuals Covered218
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $140,081
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $636,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $101,857
Insurance broker organization code?3
NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 )
Policy contract numberEAP
Policy instance 4
Insurance contract or identification numberEAP
Number of Individuals Covered238
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $3,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00937047
Policy instance 3
Insurance contract or identification number00937047
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $72
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539296
Policy instance 2
Insurance contract or identification number00539296
Number of Individuals Covered249
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $22,874
Total amount of fees paid to insurance companyUSD $6,144
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, ACCIDENT, VOL CI
Welfare Benefit Premiums Paid to CarrierUSD $151,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,874
Amount paid for insurance broker fees6144
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-202977
Policy instance 1
Insurance contract or identification numberUNI-202977
Number of Individuals Covered210
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $130,378
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $592,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $130,378
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00937047
Policy instance 3
Insurance contract or identification number00937047
Number of Individuals Covered5
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $77
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $955
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $76
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539296
Policy instance 2
Insurance contract or identification number00539296
Number of Individuals Covered244
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $21,696
Total amount of fees paid to insurance companyUSD $5,412
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, ACCIDENT, VOL CI
Welfare Benefit Premiums Paid to CarrierUSD $143,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,696
Amount paid for insurance broker fees5412
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-202977
Policy instance 1
Insurance contract or identification numberUNI-202977
Number of Individuals Covered213
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $82,144
Total amount of fees paid to insurance companyUSD $38,334
Welfare Benefit Premiums Paid to CarrierUSD $547,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $82,144
Amount paid for insurance broker fees38334
Additional information about fees paid to insurance brokerGENERAL AGENCY FEE
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00937047
Policy instance 3
Insurance contract or identification number00937047
Number of Individuals Covered5
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $76
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539296
Policy instance 2
Insurance contract or identification number00539296
Number of Individuals Covered235
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $23,528
Total amount of fees paid to insurance companyUSD $2,212
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, ACCIDENT, VOL CI
Welfare Benefit Premiums Paid to CarrierUSD $155,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,528
Amount paid for insurance broker fees2212
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
LIBERTY INSURANCE UNDERWRITERS, INC. (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberTRU000187-01
Policy instance 1
Insurance contract or identification numberTRU000187-01
Number of Individuals Covered203
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $67,707
Welfare Benefit Premiums Paid to CarrierUSD $451,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $67,707
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539296
Policy instance 5
Insurance contract or identification number00539296
Number of Individuals Covered209
Insurance policy start date2017-05-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $13,491
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, ACCIDENT, VOL CI
Welfare Benefit Premiums Paid to CarrierUSD $87,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,491
Insurance broker organization code?3
Insurance broker nameROBERT E. MILLER INSURANCE AGENCY
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 206364
Policy instance 4
Insurance contract or identification numberVAR 206364
Number of Individuals Covered81
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $587
Total amount of fees paid to insurance companyUSD $203
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $587
Amount paid for insurance broker fees143
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORS NETWORK LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 125552
Policy instance 3
Insurance contract or identification numberLTD 125552
Number of Individuals Covered186
Insurance policy start date2017-01-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $2,092
Total amount of fees paid to insurance companyUSD $1,170
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,092
Amount paid for insurance broker fees826
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORS NETWORK LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 153215
Policy instance 2
Insurance contract or identification numberGL 153215
Number of Individuals Covered194
Insurance policy start date2017-01-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $1,992
Total amount of fees paid to insurance companyUSD $1,925
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D AND VOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $32,341
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,992
Amount paid for insurance broker fees1359
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORS NETWORK LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number849601
Policy instance 1
Insurance contract or identification number849601
Number of Individuals Covered181
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $51,988
Welfare Benefit Premiums Paid to CarrierUSD $294,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,988
Insurance broker organization code?3
Insurance broker nameROBERT E. MILLER INSURANCE AGENCY

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