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EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 401k Plan overview

Plan NameEMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN
Plan identification number 501

EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN Benefits

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

401k Sponsoring company profile

EMERALD PAYROLL COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name:EMERALD PAYROLL COMPANY, LLC
Employer identification number (EIN):831195833
NAIC Classification:523900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01
5012021-04-01
5012020-04-01
5012019-04-01
5012018-04-01

Plan Statistics for EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN

401k plan membership statisitcs for EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN

Measure Date Value
2022: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-0138
Total number of active participants reported on line 7a of the Form 55002022-04-0143
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-0143
2021: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-0136
Total number of active participants reported on line 7a of the Form 55002021-04-0137
Number of retired or separated participants receiving benefits2021-04-011
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-0138
2020: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-0137
Total number of active participants reported on line 7a of the Form 55002020-04-0135
Number of retired or separated participants receiving benefits2020-04-011
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-0136
2019: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-0138
Total number of active participants reported on line 7a of the Form 55002019-04-0137
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-0137
2018: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-0136
Total number of active participants reported on line 7a of the Form 55002018-04-0137
Number of retired or separated participants receiving benefits2018-04-011
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-0138

Financial Data on EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN

Measure Date Value
2023 : EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2023 401k financial data
Total plan liabilities at end of year2023-03-31$162,270
Total plan liabilities at beginning of year2023-03-31$138,812
Total income from all sources2023-03-31$970,462
Expenses. Total of all expenses incurred2023-03-31$1,175,755
Benefits paid (including direct rollovers)2023-03-31$688,808
Total plan assets at end of year2023-03-31$32,158
Total plan assets at beginning of year2023-03-31$213,993
Value of fidelity bond covering the plan2023-03-31$3,000,000
Total contributions received or receivable from participants2023-03-31$0
Expenses. Other expenses not covered elsewhere2023-03-31$324,869
Contributions received from other sources (not participants or employers)2023-03-31$1,747
Other income received2023-03-31$262
Net income (gross income less expenses)2023-03-31$-205,293
Net plan assets at end of year (total assets less liabilities)2023-03-31$-130,112
Net plan assets at beginning of year (total assets less liabilities)2023-03-31$75,181
Total contributions received or receivable from employer(s)2023-03-31$968,453
Value of corrective distributions2023-03-31$156,991
Expenses. Administrative service providers (salaries,fees and commissions)2023-03-31$5,087
2022 : EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2022 401k financial data
Total plan liabilities at end of year2022-03-31$138,812
Total plan liabilities at beginning of year2022-03-31$52,850
Total income from all sources2022-03-31$944,698
Expenses. Total of all expenses incurred2022-03-31$930,652
Benefits paid (including direct rollovers)2022-03-31$529,632
Total plan assets at end of year2022-03-31$213,993
Total plan assets at beginning of year2022-03-31$113,985
Value of fidelity bond covering the plan2022-03-31$3,000,000
Expenses. Other expenses not covered elsewhere2022-03-31$342,584
Contributions received from other sources (not participants or employers)2022-03-31$2,585
Other income received2022-03-31$506
Net income (gross income less expenses)2022-03-31$14,046
Net plan assets at end of year (total assets less liabilities)2022-03-31$75,181
Net plan assets at beginning of year (total assets less liabilities)2022-03-31$61,135
Total contributions received or receivable from employer(s)2022-03-31$941,607
Value of corrective distributions2022-03-31$50,000
Expenses. Administrative service providers (salaries,fees and commissions)2022-03-31$8,436
2021 : EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2021 401k financial data
Total plan liabilities at end of year2021-03-31$52,850
Total plan liabilities at beginning of year2021-03-31$62,465
Total income from all sources2021-03-31$928,580
Expenses. Total of all expenses incurred2021-03-31$929,189
Benefits paid (including direct rollovers)2021-03-31$446,756
Total plan assets at end of year2021-03-31$113,985
Total plan assets at beginning of year2021-03-31$124,209
Value of fidelity bond covering the plan2021-03-31$3,000,000
Total contributions received or receivable from participants2021-03-31$0
Expenses. Other expenses not covered elsewhere2021-03-31$374,440
Contributions received from other sources (not participants or employers)2021-03-31$5,186
Other income received2021-03-31$379
Net income (gross income less expenses)2021-03-31$-609
Net plan assets at end of year (total assets less liabilities)2021-03-31$61,135
Net plan assets at beginning of year (total assets less liabilities)2021-03-31$61,744
Total contributions received or receivable from employer(s)2021-03-31$923,015
Value of corrective distributions2021-03-31$95,225
Expenses. Administrative service providers (salaries,fees and commissions)2021-03-31$12,768
2020 : EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2020 401k financial data
Total plan liabilities at end of year2020-03-31$62,465
Total plan liabilities at beginning of year2020-03-31$46,068
Total income from all sources2020-03-31$974,617
Expenses. Total of all expenses incurred2020-03-31$1,218,292
Benefits paid (including direct rollovers)2020-03-31$613,143
Total plan assets at end of year2020-03-31$124,209
Total plan assets at beginning of year2020-03-31$351,487
Value of fidelity bond covering the plan2020-03-31$3,000,000
Total contributions received or receivable from participants2020-03-31$0
Expenses. Other expenses not covered elsewhere2020-03-31$327,035
Contributions received from other sources (not participants or employers)2020-03-31$0
Other income received2020-03-31$689
Net income (gross income less expenses)2020-03-31$-243,675
Net plan assets at end of year (total assets less liabilities)2020-03-31$61,744
Net plan assets at beginning of year (total assets less liabilities)2020-03-31$305,419
Total contributions received or receivable from employer(s)2020-03-31$973,928
Value of corrective distributions2020-03-31$263,042
Expenses. Administrative service providers (salaries,fees and commissions)2020-03-31$15,072
2019 : EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2019 401k financial data
Total plan liabilities at end of year2019-03-31$46,068
Total plan liabilities at beginning of year2019-03-31$86,002
Total income from all sources2019-03-31$873,953
Expenses. Total of all expenses incurred2019-03-31$573,202
Benefits paid (including direct rollovers)2019-03-31$331,022
Total plan assets at end of year2019-03-31$351,487
Total plan assets at beginning of year2019-03-31$90,670
Value of fidelity bond covering the plan2019-03-31$1,500,000
Expenses. Other expenses not covered elsewhere2019-03-31$219,991
Other income received2019-03-31$631
Net income (gross income less expenses)2019-03-31$300,751
Net plan assets at end of year (total assets less liabilities)2019-03-31$305,419
Net plan assets at beginning of year (total assets less liabilities)2019-03-31$4,668
Total contributions received or receivable from employer(s)2019-03-31$873,322
Expenses. Administrative service providers (salaries,fees and commissions)2019-03-31$22,189

Form 5500 Responses for EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN

2022: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Submission has been amendedNo
2022-04-01This submission is the final filingNo
2022-04-01This return/report is a short plan year return/report (less than 12 months)No
2022-04-01Plan is a collectively bargained planNo
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan funding arrangement – TrustYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement - TrustYes
2021: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – TrustYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement - TrustYes
2020: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)No
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – TrustYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement - TrustYes
2019: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes
2018: EMERALD PAYROLL COMPANY, LLC GROUP MEDICAL PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – TrustYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number407354
Policy instance 1
Insurance contract or identification number407354
Number of Individuals Covered31
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
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 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 $81,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number407354
Policy instance 1
Insurance contract or identification number407354
Number of Individuals Covered39
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
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 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 $311,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number407354
Policy instance 1
Insurance contract or identification number407354
Number of Individuals Covered36
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
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 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 $299,387
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500059
Policy instance 1
Insurance contract or identification number30500059
Number of Individuals Covered37
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
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 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 $248,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered38
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
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 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 $218,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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