401k Plan data: ALFWEAR, INC plan

ALFWEAR, INC 401k Plan overview

Plan Name	ALFWEAR, INC
Plan identification number	501

ALFWEAR, INC Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

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

Company Name: ALFWEAR, INC.

Employer identification number (EIN): 870474045

NAIC Classification: 448150
NAIC Description: Clothing Accessories Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALFWEAR, INC

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01

Plan Statistics for ALFWEAR, INC

401k plan membership statisitcs for ALFWEAR, INC

Measure Date Value
2022: ALFWEAR, INC 2022 401k membership
Total participants, beginning-of-year 2022-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 223
Total of all active and inactive participants 2022-01-01 223
Total participants 2022-01-01 223

Measure	Date	Value
2022: ALFWEAR, INC 2022 401k membership
Total participants, beginning-of-year	2022-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	223
Total of all active and inactive participants	2022-01-01	223
Total participants	2022-01-01	223

Form 5500 Responses for ALFWEAR, INC

2022: ALFWEAR, INC 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )

Policy contract number

G10033801002

Policy instance

Insurance contract or identification number	G10033801002
Number of Individuals Covered	120
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $16,172
Total amount of fees paid to insurance company	USD $3,575
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,172
Amount paid for insurance broker fees	3575
Insurance broker organization code?	3

SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )

Policy contract number

G10033801003

Policy instance

Insurance contract or identification number	G10033801003
Number of Individuals Covered	2
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $357
Total amount of fees paid to insurance company	USD $70
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $357
Amount paid for insurance broker fees	70
Insurance broker organization code?	3

SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )

Policy contract number

G10033801004

Policy instance

Insurance contract or identification number	G10033801004
Number of Individuals Covered	98
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $12,667
Total amount of fees paid to insurance company	USD $2,804
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,667
Amount paid for insurance broker fees	2804
Insurance broker organization code?	3

SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )

Policy contract number

G10033801005

Policy instance

Insurance contract or identification number	G10033801005
Number of Individuals Covered	4
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $908
Total amount of fees paid to insurance company	USD $164
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $908
Amount paid for insurance broker fees	164
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

IEO UTZ311096

Policy instance

Insurance contract or identification number	IEO UTZ311096
Number of Individuals Covered	56
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,439
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,439
Insurance broker organization code?	3

OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )

Policy contract number

IEO 8UTVI311096

Policy instance

Insurance contract or identification number	IEO 8UTVI311096
Number of Individuals Covered	30
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $322
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $322
Insurance broker organization code?	3

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

INE UTZ311320

Policy instance

Insurance contract or identification number	INE UTZ311320
Number of Individuals Covered	61
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,672
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,672
Insurance broker organization code?	3

OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )

Policy contract number

INE 8UTVI311320

Policy instance

Insurance contract or identification number	INE 8UTVI311320
Number of Individuals Covered	36
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $270
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $270
Insurance broker organization code?	3

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Company Name:	ALFWEAR, INC.
Employer identification number (EIN):	870474045
NAIC Classification:	448150
NAIC Description:	Clothing Accessories Stores