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ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN 401k Plan overview

Plan NameASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN
Plan identification number 501

ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Other welfare benefit cover
  • Collectively bargained welfare benefit arrangement under Code section 419A(f)(5).

401k Sponsoring company profile

ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN has sponsored the creation of one or more 401k plans.

Company Name:ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN
Employer identification number (EIN):066321445
NAIC Classification:238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012012-01-01DONALD VALANE2014-03-14
5012011-06-01DONALD VALANE2012-10-24
5012009-06-01DONALD VALANE

Plan Statistics for ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN

401k plan membership statisitcs for ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN

Measure Date Value
2009: ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-0127
Total number of active participants reported on line 7a of the Form 55002009-06-015
Number of retired or separated participants receiving benefits2009-06-010
Number of other retired or separated participants entitled to future benefits2009-06-0113
Total of all active and inactive participants2009-06-0118
Total participants2009-06-0118
Number of employers contributing to the scheme2009-06-011

Financial Data on ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN

Measure Date Value
2011 : ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN 2011 401k financial data
Total plan liabilities at end of year2011-05-31$100,000
Total plan liabilities at beginning of year2011-05-31$100,000
Total income from all sources2011-05-31$20,408
Expenses. Total of all expenses incurred2011-05-31$103,547
Benefits paid (including direct rollovers)2011-05-31$61,113
Total plan assets at end of year2011-05-31$369,429
Total plan assets at beginning of year2011-05-31$453,568
Value of fidelity bond covering the plan2011-05-31$250,000
Total contributions received or receivable from participants2011-05-31$3,421
Expenses. Other expenses not covered elsewhere2011-05-31$36,434
Other income received2011-05-31$9,074
Net income (gross income less expenses)2011-05-31$-83,139
Net plan assets at end of year (total assets less liabilities)2011-05-31$269,429
Net plan assets at beginning of year (total assets less liabilities)2011-05-31$353,568
Total contributions received or receivable from employer(s)2011-05-31$7,913
Expenses. Administrative service providers (salaries,fees and commissions)2011-05-31$6,000

Form 5500 Responses for ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN

2009: ASBESTOS WORKERS NY/NE LOCAL 201 HEALTH PLAN 2009 form 5500 responses
2009-06-01Type of plan entityMulti-employer plan
2009-06-01Submission has been amendedNo
2009-06-01This submission is the final filingNo
2009-06-01This return/report is a short plan year return/report (less than 12 months)No
2009-06-01Plan is a collectively bargained planYes
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan funding arrangement – General assets of the sponsorYes
2009-06-01Plan benefit arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

OXFORD HEALTH PLANS NJ, INC. (National Association of Insurance Commissioners NAIC id number: 95506 )
Policy contract numberAW18443
Policy instance 1
Insurance contract or identification numberAW18443
Number of Individuals Covered4
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

Potentially related plans

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