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ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 401k Plan overview

Plan NameALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN
Plan identification number 501

ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE 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

ALTIVIA INVESTMENTS, LLC has sponsored the creation of one or more 401k plans.

Company Name:ALTIVIA INVESTMENTS, LLC
Employer identification number (EIN):814592464
NAIC Classification:325900
NAIC Description:Other Chemical Product and Preparation Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-10-01BOBBY THORNSBURY2023-03-02
5012020-10-01BOBBY THORNSBURY2022-01-28
5012019-10-01BOBBY THORNSBURY2021-04-21
5012018-10-01BOBBY THORNSBURY2020-01-28
5012017-10-01

Plan Statistics for ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN

401k plan membership statisitcs for ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN

Measure Date Value
2021: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01337
Total number of active participants reported on line 7a of the Form 55002021-10-01348
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01348
Number of employers contributing to the scheme2021-10-010
2020: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01345
Total number of active participants reported on line 7a of the Form 55002020-10-01358
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01358
Number of employers contributing to the scheme2020-10-010
2019: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01264
Total number of active participants reported on line 7a of the Form 55002019-10-01345
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01345
Number of employers contributing to the scheme2019-10-010
2018: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01231
Total number of active participants reported on line 7a of the Form 55002018-10-01264
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01264
Number of employers contributing to the scheme2018-10-010
2017: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01131
Total number of active participants reported on line 7a of the Form 55002017-10-01231
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01231
Number of employers contributing to the scheme2017-10-010

Form 5500 Responses for ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN

2021: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: ALTIVIA INVESTMENTS, LLC WELFARE AND INSURANCE PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number166187
Policy instance 2
Insurance contract or identification number166187
Number of Individuals Covered391
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $40,324
Total amount of fees paid to insurance companyUSD $4,285
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,324
Amount paid for insurance broker fees4285
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05965331
Policy instance 1
Insurance contract or identification numberKM05965331
Number of Individuals Covered1293
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $24,116
Total amount of fees paid to insurance companyUSD $57
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $261,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,116
Amount paid for insurance broker fees57
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number166187
Policy instance 2
Insurance contract or identification number166187
Number of Individuals Covered376
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $57,306
Total amount of fees paid to insurance companyUSD $3,892
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,306
Amount paid for insurance broker fees3892
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5965331
Policy instance 1
Insurance contract or identification number5965331
Number of Individuals Covered1322
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $28,332
Total amount of fees paid to insurance companyUSD $2,789
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $279,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,332
Amount paid for insurance broker fees2789
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION ADDITIONAL COMPENSATION
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number166187
Policy instance 2
Insurance contract or identification number166187
Number of Individuals Covered345
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $53,867
Total amount of fees paid to insurance companyUSD $17,166
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $53,867
Amount paid for insurance broker fees17166
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5965331
Policy instance 1
Insurance contract or identification number5965331
Number of Individuals Covered1334
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $22,257
Total amount of fees paid to insurance companyUSD $2,823
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $249,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,257
Amount paid for insurance broker fees2823
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10233891
Policy instance 2
Insurance contract or identification number10233891
Number of Individuals Covered264
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $41,567
Total amount of fees paid to insurance companyUSD $9,478
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 $277,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,567
Amount paid for insurance broker fees9478
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number542823
Policy instance 1
Insurance contract or identification number542823
Number of Individuals Covered235
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $21,313
Total amount of fees paid to insurance companyUSD $8,311
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $213,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,313
Amount paid for insurance broker fees8311
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number542823
Policy instance 1
Insurance contract or identification number542823
Number of Individuals Covered210
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $19,535
Total amount of fees paid to insurance companyUSD $1,820
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $195,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10233891
Policy instance 2
Insurance contract or identification number10233891
Number of Individuals Covered231
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $40,408
Total amount of fees paid to insurance companyUSD $3,001
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 $269,385
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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