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PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan NamePHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN
Plan identification number 501

PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

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

Company Name:PHOENIX INDUSTRIAL, INC.
Employer identification number (EIN):912171667
NAIC Classification:237990
NAIC Description:Other Heavy and Civil Engineering Construction

Additional information about PHOENIX INDUSTRIAL, INC.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 2001-12-10
Company Identification Number: 602166305
Legal Registered Office Address: 300 DESCHUTES WAY SW SUITE 208

TUMWATER
United States of America (USA)
985017719

More information about PHOENIX INDUSTRIAL, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-12-01
5012019-12-01

Plan Statistics for PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2020: PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01207
Total number of active participants reported on line 7a of the Form 55002020-12-01250
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-01250
2019: PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01207
Total number of active participants reported on line 7a of the Form 55002019-12-01207
Number of retired or separated participants receiving benefits2019-12-010
Number of other retired or separated participants entitled to future benefits2019-12-010
Total of all active and inactive participants2019-12-01207

Financial Data on PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2021 : PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-11-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-11-30No
Was this plan covered by a fidelity bond2021-11-30No
If this is an individual account plan, was there a blackout period2021-11-30No
Were there any nonexempt tranactions with any party-in-interest2021-11-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-11-30No
Value of net assets at end of year (total assets less liabilities)2021-11-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-11-30No
Were any leases to which the plan was party in default or uncollectible2021-11-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-11-30No
Was there a failure to transmit to the plan any participant contributions2021-11-30No
Has the plan failed to provide any benefit when due under the plan2021-11-30No
Did the plan have assets held for investment2021-11-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-11-30No
2020 : PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-11-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-11-30No
Was this plan covered by a fidelity bond2020-11-30No
If this is an individual account plan, was there a blackout period2020-11-30No
Were there any nonexempt tranactions with any party-in-interest2020-11-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-11-30No
Value of net assets at end of year (total assets less liabilities)2020-11-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-11-30No
Were any leases to which the plan was party in default or uncollectible2020-11-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-11-30No
Was there a failure to transmit to the plan any participant contributions2020-11-30No
Has the plan failed to provide any benefit when due under the plan2020-11-30No
Did the plan have assets held for investment2020-11-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-11-30No

Form 5500 Responses for PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN

2020: PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: PHOENIX INDUSTRIAL, INC. HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01First time form 5500 has been submittedYes
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010235118
Policy instance 4
Insurance contract or identification number000010235118
Number of Individuals Covered132
Insurance policy start date2020-11-01
Insurance policy end date2021-11-01
Total amount of commissions paid to insurance brokerUSD $4,464
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,279
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010235117
Policy instance 3
Insurance contract or identification number000010235117
Number of Individuals Covered128
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,007
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,181
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010234919
Policy instance 2
Insurance contract or identification number000010234919
Number of Individuals Covered130
Insurance policy start date2020-11-01
Insurance policy end date2021-11-01
Total amount of commissions paid to insurance brokerUSD $2,867
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,476
Insurance broker organization code?3
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number111109
Policy instance 1
Insurance contract or identification number111109
Number of Individuals Covered250
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $32,688
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,011,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,312
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010234919
Policy instance 7
Insurance contract or identification number000010234919
Number of Individuals Covered130
Insurance policy start date2020-11-01
Insurance policy end date2021-11-01
Total amount of commissions paid to insurance brokerUSD $2,867
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $19,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,476
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400234918
Policy instance 6
Insurance contract or identification number000400234918
Number of Individuals Covered155
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,929
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,660
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number00001D035572
Policy instance 5
Insurance contract or identification number00001D035572
Number of Individuals Covered127
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,757
Total amount of fees paid to insurance companyUSD $2,636
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,177
Amount paid for insurance broker fees1765
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010035572
Policy instance 5
Insurance contract or identification number000010035572
Number of Individuals Covered99
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $1,763
Total amount of fees paid to insurance companyUSD $2,645
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2645
Additional information about fees paid to insurance brokerOVERRIDES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,763
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010235118
Policy instance 4
Insurance contract or identification number000010235118
Number of Individuals Covered102
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $4,599
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,599
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010235117
Policy instance 3
Insurance contract or identification number000010235117
Number of Individuals Covered206
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $5,467
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,467
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010234919
Policy instance 2
Insurance contract or identification number000010234919
Number of Individuals Covered102
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $3,096
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,096
Insurance broker organization code?3
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number111109
Policy instance 1
Insurance contract or identification number111109
Number of Individuals Covered207
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $44,299
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,166,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,299
Insurance broker organization code?3

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