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MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 401k Plan overview

Plan NameMOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN
Plan identification number 501

MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL 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
  • Collectively bargained welfare benefit arrangement under Code section 419A(f)(5).

401k Sponsoring company profile

MOELLERING HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name:MOELLERING HOLDINGS, INC.
Employer identification number (EIN):812897412
NAIC Classification:333610

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01JOSEPH R. BAKER2023-07-13
5012021-01-01JOSEPH R. BAKER2022-07-27
5012020-01-01JOE BAKER2021-07-20
5012019-01-01ANTHONY PITTS2020-07-23 ANTHONY PITTS2020-07-23
5012018-01-01ANTHONY PITTS2019-07-29 ANTHONY PITTS2019-07-29
5012017-01-01
5012016-01-01

Plan Statistics for MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN

401k plan membership statisitcs for MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN

Measure Date Value
2022: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01197
Total number of active participants reported on line 7a of the Form 55002022-01-01204
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 participants2022-01-01206
2021: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01198
Total number of active participants reported on line 7a of the Form 55002021-01-01197
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01199
Number of employers contributing to the scheme2021-01-010
2020: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01235
Total number of active participants reported on line 7a of the Form 55002020-01-01198
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01199
Number of employers contributing to the scheme2020-01-010
2019: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01240
Total number of active participants reported on line 7a of the Form 55002019-01-01235
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01236
2018: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01260
Total number of active participants reported on line 7a of the Form 55002018-01-01230
Number of retired or separated participants receiving benefits2018-01-0110
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01240
2017: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01460
Total number of active participants reported on line 7a of the Form 55002017-01-01255
Number of retired or separated participants receiving benefits2017-01-015
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01260
2016: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01651
Total number of active participants reported on line 7a of the Form 55002016-01-01459
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01460

Form 5500 Responses for MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN

2022: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planYes
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: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan is a collectively bargained planYes
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: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan is a collectively bargained planYes
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: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planYes
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: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
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: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan is a collectively bargained planYes
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: MOELLERING HOLDINGS INC. LIFE, AD&D, MEDICAL AND DENTAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Plan is a collectively bargained planYes
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

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10361626*
Policy instance 2
Insurance contract or identification number10361626*
Number of Individuals Covered377
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,242
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $22,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,242
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BVBY
Policy instance 1
Insurance contract or identification numberG000BVBY
Number of Individuals Covered204
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,248
Total amount of fees paid to insurance companyUSD $8,105
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $108,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,248
Amount paid for insurance broker fees3905
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10361626
Policy instance 2
Insurance contract or identification number10361626
Number of Individuals Covered353
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,223
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,223
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number530065
Policy instance 1
Insurance contract or identification number530065
Number of Individuals Covered174
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,857
Total amount of fees paid to insurance companyUSD $4,332
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $41,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,857
Amount paid for insurance broker fees4332
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
MIDWESTERN VISION CENTER (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 2
Insurance contract or identification number00
Number of Individuals Covered109
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,710
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 number530065
Policy instance 1
Insurance contract or identification number530065
Number of Individuals Covered198
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $26,802
Total amount of fees paid to insurance companyUSD $9,100
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $230,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,802
Amount paid for insurance broker fees9100
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
MIDWESTERN VISION CENTER (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number
Policy instance 2
Number of Individuals Covered109
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,810
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 number00530065
Policy instance 1
Insurance contract or identification number00530065
Number of Individuals Covered235
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $22,792
Total amount of fees paid to insurance companyUSD $5,407
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT, ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $196,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,792
Amount paid for insurance broker fees5407
Additional information about fees paid to insurance brokerTOTAL FEES PAID
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number283616
Policy instance 4
Insurance contract or identification number283616
Number of Individuals Covered40
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,571
Total amount of fees paid to insurance companyUSD $265
Welfare Benefit Premiums Paid to CarrierUSD $76,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,571
Insurance broker organization code?3
Amount paid for insurance broker fees265
Insurance broker nameGALLAGHER BENEFITS SERVICES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00530065
Policy instance 3
Insurance contract or identification number00530065
Number of Individuals Covered246
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $26,554
Total amount of fees paid to insurance companyUSD $1,359
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $235,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,554
Amount paid for insurance broker fees1359
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
MIDWESTERN VISION CENTER (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number
Policy instance 2
Number of Individuals Covered109
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,810
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS NETWORK (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00-283616
Policy instance 1
Insurance contract or identification number00-283616
Number of Individuals Covered255
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $271,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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