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NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN 401k Plan overview

Plan NameNELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN
Plan identification number 502

NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

NELBUD SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:NELBUD SERVICES, LLC
Employer identification number (EIN):871783194
NAIC Classification:561720
NAIC Description:Janitorial Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01

Plan Statistics for NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN

401k plan membership statisitcs for NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN

Measure Date Value
2022: NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01141
Total number of active participants reported on line 7a of the Form 55002022-01-01687
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01687
2021: NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01140
Total number of active participants reported on line 7a of the Form 55002021-01-01141
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01141

Financial Data on NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN

Measure Date Value
2021 : NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$74,957
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$81,474
Total income from all sources (including contributions)2021-12-31$1,220,725
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,453,743
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,336,651
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,219,827
Value of total assets at end of year2021-12-31$147,755
Value of total assets at beginning of year2021-12-31$387,290
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$117,092
Total interest from all sources2021-12-31$898
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$2,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$413,355
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$123,064
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$73,153
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$76,709
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-233,018
Value of net assets at end of year (total assets less liabilities)2021-12-31$72,798
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$305,816
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$147,755
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$387,290
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$387,290
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$898
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$275,969
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Assets. Invements in employer securities at end of year2021-12-31$0
Assets. Invements in employer securities at beginning of year2021-12-31$0
Contributions received in cash from employer2021-12-31$683,408
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,060,682
Contract administrator fees2021-12-31$117,092
Liabilities. Value of benefit claims payable at end of year2021-12-31$1,804
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$4,765
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31SOMERSET CPAS, P.C.
Accountancy firm EIN2021-12-31201717681

Form 5500 Responses for NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN

2022: NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NELBUD SERVICES, LLC GROUP HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-203163
Policy instance 1
Insurance contract or identification numberUNI-203163
Number of Individuals Covered1614
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $333,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered141
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $275,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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