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PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan NamePLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN
Plan identification number 501

PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

PLANET GRANITE, INC. has sponsored the creation of one or more 401k plans.

Company Name:PLANET GRANITE, INC.
Employer identification number (EIN):841501370
NAIC Classification:238900

Additional information about PLANET GRANITE, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1999-03-26
Company Identification Number: 19991057254
Legal Registered Office Address: 3020 N Stone Ave

Colorado Springs
United States of America (USA)
80907

More information about PLANET GRANITE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-12-01NONNIE SALAMON2023-01-26
5012020-12-01NONNIE SALAMON2022-02-01
5012019-12-01NONNIE SALAMON2021-01-22

Plan Statistics for PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN

Measure Date Value
2021: PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-01103
Total number of active participants reported on line 7a of the Form 55002021-12-01110
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-01110
Number of employers contributing to the scheme2021-12-010
2020: PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01106
Total number of active participants reported on line 7a of the Form 55002020-12-01103
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-01103
Number of employers contributing to the scheme2020-12-010
2019: PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01100
Total number of active participants reported on line 7a of the Form 55002019-12-01106
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01106
Number of employers contributing to the scheme2019-12-010

Form 5500 Responses for PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN

2021: PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – InsuranceYes
2020: PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: PLANET GRANITE, INC. EMPLOYEE BENEFITS PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01First time form 5500 has been submittedYes
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number648036
Policy instance 4
Insurance contract or identification number648036
Number of Individuals Covered113
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $9,509
Total amount of fees paid to insurance companyUSD $128
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $87,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,509
Amount paid for insurance broker fees128
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number25009
Policy instance 3
Insurance contract or identification number25009
Number of Individuals Covered26
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $602
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $6,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $602
Amount paid for insurance broker fees0
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4415394
Policy instance 2
Insurance contract or identification numberE4415394
Number of Individuals Covered62
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $1,794
Total amount of fees paid to insurance companyUSD $108
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $12,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $610
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number648036
Policy instance 1
Insurance contract or identification number648036
Number of Individuals Covered84
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $24,612
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $519,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,949
Amount paid for insurance broker fees0
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number648036
Policy instance 4
Insurance contract or identification number648036
Number of Individuals Covered111
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $8,610
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $82,439
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,356
Amount paid for insurance broker fees0
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number25009
Policy instance 3
Insurance contract or identification number25009
Number of Individuals Covered27
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $741
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $7,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $741
Amount paid for insurance broker fees0
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4415394
Policy instance 2
Insurance contract or identification numberE4415394
Number of Individuals Covered62
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $2,230
Total amount of fees paid to insurance companyUSD $220
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $12,408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $775
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number648036
Policy instance 1
Insurance contract or identification number648036
Number of Individuals Covered90
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $38,084
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $508,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,626
Amount paid for insurance broker fees0
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number25009
Policy instance 5
Insurance contract or identification number25009
Number of Individuals Covered28
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $1,164
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $5,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,164
Amount paid for insurance broker fees0
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4415394
Policy instance 4
Insurance contract or identification numberE4415394
Number of Individuals Covered54
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $1,980
Total amount of fees paid to insurance companyUSD $189
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $12,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $648
Amount paid for insurance broker fees50
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number648036
Policy instance 3
Insurance contract or identification number648036
Number of Individuals Covered106
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $2,800
Total amount of fees paid to insurance companyUSD $225
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $22,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,800
Amount paid for insurance broker fees225
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number648036
Policy instance 2
Insurance contract or identification number648036
Number of Individuals Covered87
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $8,723
Total amount of fees paid to insurance companyUSD $860
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,723
Amount paid for insurance broker fees860
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number648036
Policy instance 1
Insurance contract or identification number648036
Number of Individuals Covered99
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $31,579
Total amount of fees paid to insurance companyUSD $2,604
Health Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $451,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,579
Amount paid for insurance broker fees2604
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3

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