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CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 401k Plan overview

Plan NameCLEANPART INTERNATIONAL, INC. MEDICAL PLAN
Plan identification number 501

CLEANPART INTERNATIONAL, INC. MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

CLEANPART USA, INC. has sponsored the creation of one or more 401k plans.

Company Name:CLEANPART USA, INC.
Employer identification number (EIN):861107725
NAIC Classification:334410

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLEANPART INTERNATIONAL, INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-04-01LESLIE ARNO2024-11-01
5012022-04-01LESLIE ARNO2023-10-27
5012021-04-01LESLIE ARNO2022-10-13
5012020-04-01LESLIE ARNO2021-09-13
5012019-04-01LESLIE ARNO2020-09-11
5012017-04-01
5012016-04-01
5012015-04-01LESLIE ARNO
5012011-04-01LESLIE ARNO

Plan Statistics for CLEANPART INTERNATIONAL, INC. MEDICAL PLAN

401k plan membership statisitcs for CLEANPART INTERNATIONAL, INC. MEDICAL PLAN

Measure Date Value
2023: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year2023-04-01109
Total number of active participants reported on line 7a of the Form 55002023-04-01104
Number of retired or separated participants receiving benefits2023-04-010
Number of other retired or separated participants entitled to future benefits2023-04-010
Total of all active and inactive participants2023-04-01104
Number of employers contributing to the scheme2023-04-010
2022: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01109
Total number of active participants reported on line 7a of the Form 55002022-04-01109
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 participants2022-04-01109
Number of employers contributing to the scheme2022-04-010
2021: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01107
Total number of active participants reported on line 7a of the Form 55002021-04-01109
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01109
Number of employers contributing to the scheme2021-04-010
2020: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01126
Total number of active participants reported on line 7a of the Form 55002020-04-01107
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01107
Number of employers contributing to the scheme2020-04-010
2019: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01123
Total number of active participants reported on line 7a of the Form 55002019-04-01123
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 participants2019-04-01123
Number of employers contributing to the scheme2019-04-010
2017: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01100
Total number of active participants reported on line 7a of the Form 55002017-04-01114
Number of retired or separated participants receiving benefits2017-04-012
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01116
2016: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01103
Total number of active participants reported on line 7a of the Form 55002016-04-01105
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01105
2015: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01113
Total number of active participants reported on line 7a of the Form 55002015-04-01103
Number of retired or separated participants receiving benefits2015-04-010
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01103
2011: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-0179
Total number of active participants reported on line 7a of the Form 55002011-04-0195
Number of retired or separated participants receiving benefits2011-04-010
Number of other retired or separated participants entitled to future benefits2011-04-010
Total of all active and inactive participants2011-04-0195

Form 5500 Responses for CLEANPART INTERNATIONAL, INC. MEDICAL PLAN

2023: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2023 form 5500 responses
2023-04-01Type of plan entitySingle employer plan
2023-04-01Plan funding arrangement – InsuranceYes
2023-04-01Plan benefit arrangement – InsuranceYes
2022: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2017: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2011: CLEANPART INTERNATIONAL, INC. MEDICAL PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01First time form 5500 has been submittedYes
2011-04-01Submission has been amendedYes
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-044930
Policy instance 2
Insurance contract or identification number10-044930
Number of Individuals Covered228
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $12,986
Total amount of fees paid to insurance companyUSD $2,173
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $129,857
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 number911082
Policy instance 1
Insurance contract or identification number911082
Number of Individuals Covered180
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $75,249
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,551,153
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-044930
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number911082
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-044930
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number911082
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-044930
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number911082
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-044930
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number911082
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number01004493000002
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number911082
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12253071
Policy instance 3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number492725
Policy instance 2
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95490 )
Policy contract number492725HNO
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12253071
Policy instance 4
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number154619
Policy instance 3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number492725
Policy instance 2
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95490 )
Policy contract numberUS436677
Policy instance 1

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