401k Plan data: GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN plan

GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN
Plan identification number	501

GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare 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

GUNDERSON MARINE, LLC has sponsored the creation of one or more 401k plans.

Company Name: GUNDERSON MARINE, LLC

Employer identification number (EIN): 931357619

NAIC Classification: 336610

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-07-01 VINCE MARRELLA 2024-12-09

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-07-01	VINCE MARRELLA	2024-12-09

Plan Statistics for GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN

Measure Date Value
2023: GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-07-01 300
Total number of active participants reported on line 7a of the Form 5500 2023-07-01 280
Number of retired or separated participants receiving benefits 2023-07-01 0
Number of other retired or separated participants entitled to future benefits 2023-07-01 0
Total of all active and inactive participants 2023-07-01 280
Number of employers contributing to the scheme 2023-07-01 0

Measure	Date	Value
2023: GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-07-01	300
Total number of active participants reported on line 7a of the Form 5500	2023-07-01	280
Number of retired or separated participants receiving benefits	2023-07-01	0
Number of other retired or separated participants entitled to future benefits	2023-07-01	0
Total of all active and inactive participants	2023-07-01	280
Number of employers contributing to the scheme	2023-07-01	0

Form 5500 Responses for GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN

2023: GUNDERSON MARINE, LLC WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-07-01	Type of plan entity	Single employer plan
2023-07-01	First time form 5500 has been submitted	Yes
2023-07-01	Plan funding arrangement – Insurance	Yes
2023-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-07-01	Plan benefit arrangement – Insurance	Yes
2023-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )

Policy contract number

122137

Policy instance

Insurance contract or identification number	122137
Number of Individuals Covered	355
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $42,855
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,428,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )

Policy contract number

25397

Policy instance

Insurance contract or identification number	25397
Number of Individuals Covered	204
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $32,625
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,419,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 )

Policy contract number

10019461

Policy instance

Insurance contract or identification number	10019461
Number of Individuals Covered	585
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $11,849
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $237,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CASCADE CENTERS INC. (National Association of Insurance Commissioners NAIC id number: 62133 )

Policy contract number

Policy instance

Insurance contract or identification number	00
Number of Individuals Covered	280
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $8,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX0970391

Policy instance

Insurance contract or identification number	FLX0970391
Number of Individuals Covered	280
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $7,854
Total amount of fees paid to insurance company	USD $25,340
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $157,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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Company Name:	GUNDERSON MARINE, LLC
Employer identification number (EIN):	931357619
NAIC Classification:	336610