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CAPACITY COVERAGE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameCAPACITY COVERAGE WELFARE BENEFIT PLAN
Plan identification number 501

CAPACITY COVERAGE WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

CAPACITY COVERAGE COMPANY OF NEW JERSEY, LLC has sponsored the creation of one or more 401k plans.

Company Name:CAPACITY COVERAGE COMPANY OF NEW JERSEY, LLC
Employer identification number (EIN):820858343
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Additional information about CAPACITY COVERAGE COMPANY OF NEW JERSEY, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2017-07-14
Company Identification Number: 0802771516

More information about CAPACITY COVERAGE COMPANY OF NEW JERSEY, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAPACITY COVERAGE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-01-01
5012017-01-01STEVE KLOS
5012017-01-01STEVE KLOS

Plan Statistics for CAPACITY COVERAGE WELFARE BENEFIT PLAN

401k plan membership statisitcs for CAPACITY COVERAGE WELFARE BENEFIT PLAN

Measure Date Value
2018: CAPACITY COVERAGE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01144
Total number of active participants reported on line 7a of the Form 55002018-01-01158
Total of all active and inactive participants2018-01-01158
2017: CAPACITY COVERAGE WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01149
Total number of active participants reported on line 7a of the Form 55002017-01-01142
Total of all active and inactive participants2017-01-01142
Total participants2017-01-01142

Form 5500 Responses for CAPACITY COVERAGE WELFARE BENEFIT PLAN

2018: CAPACITY COVERAGE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: CAPACITY COVERAGE WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961913
Policy instance 6
Insurance contract or identification numberVDT961913
Insurance policy start date2017-07-01
Insurance policy end date2018-07-01
Long Term Disability Insurance Welfare BenefitYes
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK968326
Policy instance 5
Insurance contract or identification numberOK968326
Insurance policy start date2017-07-01
Insurance policy end date2018-07-01
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00488506
Policy instance 4
Insurance contract or identification number00488506
Number of Individuals Covered100
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,838
Total amount of fees paid to insurance companyUSD $686
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $636
Amount paid for insurance broker fees686
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0613847
Policy instance 3
Insurance contract or identification number0613847
Number of Individuals Covered116
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $8,461
Total amount of fees paid to insurance companyUSD $3,823
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,461
Insurance broker organization code?3
Amount paid for insurance broker fees3823
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966817
Policy instance 2
Insurance contract or identification numberFLX966817
Insurance policy start date2017-07-01
Insurance policy end date2018-07-01
Life Insurance Welfare BenefitYes
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00613847
Policy instance 1
Insurance contract or identification number00613847
Number of Individuals Covered156
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $56,160
Total amount of fees paid to insurance companyUSD $53,282
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $555,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $56,160
Amount paid for insurance broker fees26676
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961913
Policy instance 6
Insurance contract or identification numberVDT961913
Insurance policy start date2016-07-01
Insurance policy end date2017-07-01
Total amount of commissions paid to insurance brokerUSD $3,957
Total amount of fees paid to insurance companyUSD $1,958
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,957
Additional information about fees paid to insurance brokerSALES & SERVICE
Amount paid for insurance broker fees1958
Insurance broker namePPI BENEFIT SOLUTIONS
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK968326
Policy instance 5
Insurance contract or identification numberOK968326
Insurance policy start date2016-07-01
Insurance policy end date2017-07-01
Total amount of commissions paid to insurance brokerUSD $260
Total amount of fees paid to insurance companyUSD $109
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $260
Additional information about fees paid to insurance brokerSALES & SERVICE
Amount paid for insurance broker fees109
Insurance broker namePPI BENEFIT SOLUTIONS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00488506
Policy instance 4
Insurance contract or identification number00488506
Number of Individuals Covered105
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $2,073
Total amount of fees paid to insurance companyUSD $593
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,320
Amount paid for insurance broker fees593
Insurance broker nameNRL WEALTH CREATION STRAT
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0613847
Policy instance 3
Insurance contract or identification number0613847
Number of Individuals Covered144
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $9,382
Total amount of fees paid to insurance companyUSD $4,132
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,382
Amount paid for insurance broker fees4132
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT PAYMENTS
Insurance broker organization code?3
Insurance broker namePROFESSIONAL PENSIONS INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966817
Policy instance 2
Insurance contract or identification numberFLX966817
Insurance policy start date2016-07-01
Insurance policy end date2017-07-01
Total amount of commissions paid to insurance brokerUSD $2,011
Total amount of fees paid to insurance companyUSD $1,079
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPPLIMENTAL LIFE, DEPENDENT LIFE
Welfare Benefit Premiums Paid to CarrierUSD $21,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,011
Amount paid for insurance broker fees1079
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker namePPI BENEFIT SOLUTIONS
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00613847
Policy instance 1
Insurance contract or identification number00613847
Number of Individuals Covered142
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $68,480
Total amount of fees paid to insurance companyUSD $65,190
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $600,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $68,480
Amount paid for insurance broker fees32748
Insurance broker namePROFESSIONAL PENSIONS INC

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