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CLYSAR, LLC DENTAL PLAN 401k Plan overview

Plan NameCLYSAR, LLC DENTAL PLAN
Plan identification number 501

CLYSAR, LLC DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

CLYSAR LLC has sponsored the creation of one or more 401k plans.

Company Name:CLYSAR LLC
Employer identification number (EIN):017227296
NAIC Classification:326100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLYSAR, LLC DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-01-01LISA TRAVIS-HILBERT
5012014-01-01LISA TRAVIS-HILBERT
5012013-01-01LISA TRAVIS-HILBERT LISA TRAVIS-HILBERT2014-07-29

Plan Statistics for CLYSAR, LLC DENTAL PLAN

401k plan membership statisitcs for CLYSAR, LLC DENTAL PLAN

Measure Date Value
2015: CLYSAR, LLC DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01287
Total number of active participants reported on line 7a of the Form 55002015-01-01293
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01295
2014: CLYSAR, LLC DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01262
Total number of active participants reported on line 7a of the Form 55002014-01-01287
Total of all active and inactive participants2014-01-01287
Total participants2014-01-01287
2013: CLYSAR, LLC DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-010
Total number of active participants reported on line 7a of the Form 55002013-01-01262
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01262
Number of participants with account balances2013-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010

Form 5500 Responses for CLYSAR, LLC DENTAL PLAN

2015: CLYSAR, LLC DENTAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: CLYSAR, LLC DENTAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: CLYSAR, LLC DENTAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number1269
Policy instance 1
Insurance contract or identification number1269
Number of Individuals Covered287
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $8,026
Total amount of fees paid to insurance companyUSD $2,080
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
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 $239,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,026
Amount paid for insurance broker fees2080
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
Insurance broker nameKRAUTER & COMPANY
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number1269
Policy instance 1
Insurance contract or identification number1269
Number of Individuals Covered262
Insurance policy start date2013-09-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,299
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
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 $74,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,299
Insurance broker organization code?3
Insurance broker nameKRAUTER & COMPANY

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