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GROUP LONG TERM CARE 401k Plan overview

Plan NameGROUP LONG TERM CARE
Plan identification number 502

GROUP LONG TERM CARE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Other welfare benefit cover

401k Sponsoring company profile

CLARK INSURANCE has sponsored the creation of one or more 401k plans.

Company Name:CLARK INSURANCE
Employer identification number (EIN):010046400
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Additional information about CLARK INSURANCE

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2007-10-01
Company Identification Number: 0800878850
Legal Registered Office Address: 1166 AVENUE OF THE AMERICAS FL 36

NEW YORK
United States of America (USA)
10036

More information about CLARK INSURANCE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LONG TERM CARE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-12-01

Plan Statistics for GROUP LONG TERM CARE

401k plan membership statisitcs for GROUP LONG TERM CARE

Measure Date Value
2022: GROUP LONG TERM CARE 2022 401k membership
Total participants, beginning-of-year2022-12-01111
Total number of active participants reported on line 7a of the Form 55002022-12-01129
Number of retired or separated participants receiving benefits2022-12-010
Number of other retired or separated participants entitled to future benefits2022-12-010
Total of all active and inactive participants2022-12-01129

Form 5500 Responses for GROUP LONG TERM CARE

2022: GROUP LONG TERM CARE 2022 form 5500 responses
2022-12-01Type of plan entitySingle employer plan
2022-12-01First time form 5500 has been submittedYes
2022-12-01Submission has been amendedNo
2022-12-01This submission is the final filingNo
2022-12-01This return/report is a short plan year return/report (less than 12 months)No
2022-12-01Plan is a collectively bargained planNo
2022-12-01Plan funding arrangement – InsuranceYes
2022-12-01Plan funding arrangement – General assets of the sponsorYes
2022-12-01Plan benefit arrangement – InsuranceYes
2022-12-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number588897
Policy instance 1
Insurance contract or identification number588897
Number of Individuals Covered129
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $12,082
Total amount of fees paid to insurance companyUSD $0
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
Other welfare benefits providedGROUP LONG TERM CARE, GROUP INDIV LTC
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 $75,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,082
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3

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