LESSEN LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LESSEN LLC HEALTH AND WELFARE PLAN
| 2023: LESSEN LLC HEALTH AND WELFARE PLAN 2023 form 5500 responses |
|---|
| 2023-08-01 | Type of plan entity | Single employer plan |
| 2023-08-01 | Plan funding arrangement – Insurance | Yes |
| 2023-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-08-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2023-05-01 | Type of plan entity | Single employer plan |
| 2023-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2023-05-01 | Plan funding arrangement – Insurance | Yes |
| 2023-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: LESSEN LLC HEALTH AND WELFARE PLAN 2022 form 5500 responses |
|---|
| 2022-05-01 | Type of plan entity | Single employer plan |
| 2022-05-01 | First time form 5500 has been submitted | Yes |
| 2022-05-01 | Plan funding arrangement – Insurance | Yes |
| 2022-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 251175 |
| Policy instance | 1 |
| Insurance contract or identification number | 251175 | | Number of Individuals Covered | 803 | | Insurance policy start date | 2023-08-01 | | Insurance policy end date | 2024-07-31 | | Total amount of commissions paid to insurance broker | USD $47,968 | | Total amount of fees paid to insurance company | USD $28,336 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $574,926 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 938705 |
| Policy instance | 2 |
| Insurance contract or identification number | 938705 | | Number of Individuals Covered | 1056 | | Insurance policy start date | 2023-08-01 | | Insurance policy end date | 2024-07-31 | | Total amount of commissions paid to insurance broker | USD $51,225 | | Total amount of fees paid to insurance company | USD $11,878 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $365,944 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
| Policy contract number | 938708 |
| Policy instance | 3 |
| Insurance contract or identification number | 938708 | | Number of Individuals Covered | 181 | | Insurance policy start date | 2023-08-01 | | Insurance policy end date | 2024-07-31 | | Total amount of commissions paid to insurance broker | USD $4,704 | | Total amount of fees paid to insurance company | USD $776 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS, HOSPITAL | | Welfare Benefit Premiums Paid to Carrier | USD $45,918 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 927705 |
| Policy instance | 1 |
| Insurance contract or identification number | 927705 | | Number of Individuals Covered | 322 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2023-07-31 | | Total amount of commissions paid to insurance broker | USD $19,260 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $636,196 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1127420 |
| Policy instance | 2 |
| Insurance contract or identification number | 1127420 | | Number of Individuals Covered | 477 | | Insurance policy start date | 2023-05-01 | | Insurance policy end date | 2023-07-31 | | Total amount of commissions paid to insurance broker | USD $24,115 | | Total amount of fees paid to insurance company | USD $168 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $93,159 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 927705 |
| Policy instance | 1 |
| Insurance contract or identification number | 927705 | | Number of Individuals Covered | 600 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $171,600 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,135,780 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1127420 |
| Policy instance | 2 |
| Insurance contract or identification number | 1127420 | | Number of Individuals Covered | 614 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $116,911 | | Total amount of fees paid to insurance company | USD $5,786 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $632,108 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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