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QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameQUINAULT INDIAN NATION HEALTH AND WELFARE PLAN
Plan identification number 502

QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

QUINAULT INDIAN NATION has sponsored the creation of one or more 401k plans.

Company Name:QUINAULT INDIAN NATION
Employer identification number (EIN):910760952
NAIC Classification:921000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01LYNN L. CRIST2023-05-19
5022021-01-01KIM A AIKEN2022-08-15
5022020-01-01KIM A AIKEN2021-07-02
5022019-01-01KIM A. AIKEN2020-06-24
5022018-01-01LYNN L. CRIST2019-09-03

Plan Statistics for QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN

401k plan membership statisitcs for QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN

Measure Date Value
2022: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01492
Total number of active participants reported on line 7a of the Form 55002022-01-01492
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 participants2022-01-01492
Number of employers contributing to the scheme2022-01-010
2021: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01284
Total number of active participants reported on line 7a of the Form 55002021-01-01492
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 participants2021-01-01492
Number of employers contributing to the scheme2021-01-010
2020: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01393
Total number of active participants reported on line 7a of the Form 55002020-01-01284
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01284
Number of employers contributing to the scheme2020-01-010
2019: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01413
Total number of active participants reported on line 7a of the Form 55002019-01-01393
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01393
Number of employers contributing to the scheme2019-01-010
2018: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01359
Total number of active participants reported on line 7a of the Form 55002018-01-01413
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01413
Number of employers contributing to the scheme2018-01-010

Form 5500 Responses for QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN

2022: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
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: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: QUINAULT INDIAN NATION HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-020366-00
Policy instance 1
Insurance contract or identification number01-020366-00
Number of Individuals Covered492
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,281
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $250,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees5281
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number892179G
Policy instance 1
Insurance contract or identification number892179G
Number of Individuals Covered516
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $13,887
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $248,913
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 fees13887
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )
Policy contract number09634
Policy instance 1
Insurance contract or identification number09634
Number of Individuals Covered873
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
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 number45132
Policy instance 2
Insurance contract or identification number45132
Number of Individuals Covered284
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $26,675
Total amount of fees paid to insurance companyUSD $9,387
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
Welfare Benefit Premiums Paid to CarrierUSD $157,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,675
Amount paid for insurance broker fees9387
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number45132 0001
Policy instance 1
Insurance contract or identification number45132 0001
Number of Individuals Covered393
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $27,906
Total amount of fees paid to insurance companyUSD $7,525
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
Welfare Benefit Premiums Paid to CarrierUSD $452,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,508
Amount paid for insurance broker fees2565
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number45132 0001
Policy instance 1
Insurance contract or identification number45132 0001
Number of Individuals Covered413
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $21,730
Total amount of fees paid to insurance companyUSD $3,739
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
Welfare Benefit Premiums Paid to CarrierUSD $299,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,730
Amount paid for insurance broker fees3739
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3

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