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WOVEN BY TOYOTA, U.S., INC. HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameWOVEN BY TOYOTA, U.S., INC. HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 501

WOVEN BY TOYOTA, U.S., INC. HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

WOVEN PLANET NORTH AMERICA, INC. has sponsored the creation of one or more 401k plans.

Company Name:WOVEN PLANET NORTH AMERICA, INC.
Employer identification number (EIN):862554188
NAIC Classification:551112
NAIC Description:Offices of Other Holding Companies

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WOVEN BY TOYOTA, U.S., INC. HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01NANCY JI2023-10-02

Plan Statistics for WOVEN BY TOYOTA, U.S., INC. HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for WOVEN BY TOYOTA, U.S., INC. HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2022: WOVEN BY TOYOTA, U.S., INC. HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01134
Total number of active participants reported on line 7a of the Form 55002022-05-01554
Number of retired or separated participants receiving benefits2022-05-013
Number of other retired or separated participants entitled to future benefits2022-05-0112
Total of all active and inactive participants2022-05-01569
Number of employers contributing to the scheme2022-05-010

Form 5500 Responses for WOVEN BY TOYOTA, U.S., INC. HEALTH AND WELFARE BENEFIT PLAN

2022: WOVEN BY TOYOTA, U.S., INC. HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01First time form 5500 has been submittedYes
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW8001492
Policy instance 1
Insurance contract or identification numberW8001492
Number of Individuals Covered845
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $373,407
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,094,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees373407
Additional information about fees paid to insurance brokerPRODUCER SERVICE FEE
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number607391
Policy instance 2
Insurance contract or identification number607391
Number of Individuals Covered205
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $26,595
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $606,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,595
Amount paid for insurance broker fees0
Insurance broker organization code?3
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number120939-1
Policy instance 3
Insurance contract or identification number120939-1
Number of Individuals Covered554
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5395206
Policy instance 4
Insurance contract or identification number5395206
Number of Individuals Covered1024
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $38,868
Total amount of fees paid to insurance companyUSD $10,799
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $539,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,868
Amount paid for insurance broker fees9733
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number40148418
Policy instance 5
Insurance contract or identification number40148418
Number of Individuals Covered509
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $10,300
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,300
Amount paid for insurance broker fees0
Insurance broker organization code?3
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract numberGTP 0009159800
Policy instance 6
Insurance contract or identification numberGTP 0009159800
Number of Individuals Covered554
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $1,582
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $6,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,582
Amount paid for insurance broker fees0
Insurance broker organization code?3
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )
Policy contract number4EL-9146-22
Policy instance 7
Insurance contract or identification number4EL-9146-22
Number of Individuals Covered20
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $2,746
Total amount of fees paid to insurance companyUSD $3,295
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,746
Amount paid for insurance broker fees3295
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number981005
Policy instance 8
Insurance contract or identification number981005
Number of Individuals Covered215
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $2,314
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $24,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,314
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number714362
Policy instance 9
Insurance contract or identification number714362
Number of Individuals Covered554
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $33,771
Total amount of fees paid to insurance companyUSD $13,508
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $337,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,771
Amount paid for insurance broker fees13508
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3

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