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K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 401k Plan overview

Plan NameK & W TIRE COMPANY, INC. GROUP MEDICAL PLAN
Plan identification number 501

K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

K & W TIRE COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name:K & W TIRE COMPANY, INC.
Employer identification number (EIN):231706509
NAIC Classification:336300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01
5012021-07-01
5012020-07-01
5012020-04-01
5012019-04-01

Plan Statistics for K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN

401k plan membership statisitcs for K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN

Measure Date Value
2022: K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-0154
Total number of active participants reported on line 7a of the Form 55002022-07-0148
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-0148
2021: K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-0153
Total number of active participants reported on line 7a of the Form 55002021-07-0153
Number of retired or separated participants receiving benefits2021-07-011
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-0154
2020: K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-0172
Total number of active participants reported on line 7a of the Form 55002020-07-0152
Number of retired or separated participants receiving benefits2020-07-011
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-0153
Total participants, beginning-of-year2020-04-0177
Total number of active participants reported on line 7a of the Form 55002020-04-0177
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-0177
2019: K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-0172
Total number of active participants reported on line 7a of the Form 55002019-04-0172
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-0172

Financial Data on K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN

Measure Date Value
2023 : K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2023 401k financial data
Total plan liabilities at end of year2023-06-30$32,430
Total plan liabilities at beginning of year2023-06-30$50,144
Total income from all sources2023-06-30$618,057
Expenses. Total of all expenses incurred2023-06-30$450,371
Benefits paid (including direct rollovers)2023-06-30$184,905
Total plan assets at end of year2023-06-30$262,512
Total plan assets at beginning of year2023-06-30$112,540
Value of fidelity bond covering the plan2023-06-30$500,000
Total contributions received or receivable from participants2023-06-30$88,100
Expenses. Other expenses not covered elsewhere2023-06-30$222,359
Contributions received from other sources (not participants or employers)2023-06-30$0
Other income received2023-06-30$1,756
Net income (gross income less expenses)2023-06-30$167,686
Net plan assets at end of year (total assets less liabilities)2023-06-30$230,082
Net plan assets at beginning of year (total assets less liabilities)2023-06-30$62,396
Total contributions received or receivable from employer(s)2023-06-30$528,201
Value of corrective distributions2023-06-30$29,934
Expenses. Administrative service providers (salaries,fees and commissions)2023-06-30$13,173
2022 : K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2022 401k financial data
Total plan liabilities at end of year2022-06-30$50,144
Total plan liabilities at beginning of year2022-06-30$79,418
Total income from all sources2022-06-30$602,499
Expenses. Total of all expenses incurred2022-06-30$590,490
Benefits paid (including direct rollovers)2022-06-30$306,146
Total plan assets at end of year2022-06-30$112,540
Total plan assets at beginning of year2022-06-30$129,805
Value of fidelity bond covering the plan2022-06-30$500,000
Total contributions received or receivable from participants2022-06-30$94,617
Expenses. Other expenses not covered elsewhere2022-06-30$232,561
Contributions received from other sources (not participants or employers)2022-06-30$0
Other income received2022-06-30$237
Net income (gross income less expenses)2022-06-30$12,009
Net plan assets at end of year (total assets less liabilities)2022-06-30$62,396
Net plan assets at beginning of year (total assets less liabilities)2022-06-30$50,387
Total contributions received or receivable from employer(s)2022-06-30$507,645
Value of corrective distributions2022-06-30$41,907
Expenses. Administrative service providers (salaries,fees and commissions)2022-06-30$9,876
2021 : K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2021 401k financial data
Total plan liabilities at end of year2021-06-30$79,418
Total plan liabilities at beginning of year2021-06-30$324,995
Total income from all sources2021-06-30$533,402
Expenses. Total of all expenses incurred2021-06-30$208,219
Benefits paid (including direct rollovers)2021-06-30$-1,994
Total plan assets at end of year2021-06-30$129,805
Total plan assets at beginning of year2021-06-30$50,199
Value of fidelity bond covering the plan2021-06-30$300,000
Total contributions received or receivable from participants2021-06-30$104,780
Expenses. Other expenses not covered elsewhere2021-06-30$194,435
Contributions received from other sources (not participants or employers)2021-06-30$2,182
Other income received2021-06-30$222
Net income (gross income less expenses)2021-06-30$325,183
Net plan assets at end of year (total assets less liabilities)2021-06-30$50,387
Net plan assets at beginning of year (total assets less liabilities)2021-06-30$-274,796
Total contributions received or receivable from employer(s)2021-06-30$426,218
Value of corrective distributions2021-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-06-30$15,778
2020 : K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2020 401k financial data
Total plan liabilities at end of year2020-06-30$324,995
Total plan liabilities at beginning of year2020-06-30$177,254
Total income from all sources2020-06-30$183,392
Expenses. Total of all expenses incurred2020-06-30$340,513
Benefits paid (including direct rollovers)2020-06-30$273,954
Total plan assets at end of year2020-06-30$50,199
Total plan assets at beginning of year2020-06-30$59,579
Value of fidelity bond covering the plan2020-06-30$300,000
Total contributions received or receivable from participants2020-06-30$35,136
Expenses. Other expenses not covered elsewhere2020-06-30$61,512
Contributions received from other sources (not participants or employers)2020-06-30$0
Other income received2020-06-30$29
Net income (gross income less expenses)2020-06-30$-157,121
Net plan assets at end of year (total assets less liabilities)2020-06-30$-274,796
Net plan assets at beginning of year (total assets less liabilities)2020-06-30$-117,675
Total contributions received or receivable from employer(s)2020-06-30$148,227
Value of corrective distributions2020-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-06-30$5,047
Total plan liabilities at end of year2020-03-31$177,254
Total plan liabilities at beginning of year2020-03-31$0
Total income from all sources2020-03-31$772,645
Expenses. Total of all expenses incurred2020-03-31$890,320
Benefits paid (including direct rollovers)2020-03-31$605,329
Total plan assets at end of year2020-03-31$59,579
Total plan assets at beginning of year2020-03-31$0
Value of fidelity bond covering the plan2020-03-31$300,000
Total contributions received or receivable from participants2020-03-31$174,105
Expenses. Other expenses not covered elsewhere2020-03-31$255,935
Contributions received from other sources (not participants or employers)2020-03-31$0
Other income received2020-03-31$99
Net income (gross income less expenses)2020-03-31$-117,675
Net plan assets at end of year (total assets less liabilities)2020-03-31$-117,675
Net plan assets at beginning of year (total assets less liabilities)2020-03-31$0
Total contributions received or receivable from employer(s)2020-03-31$598,441
Value of corrective distributions2020-03-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-03-31$29,056

Form 5500 Responses for K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN

2022: K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedNo
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – TrustYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement - TrustYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2020-04-01Type of plan entitySingle employer plan
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – TrustYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement - TrustYes
2019: K & W TIRE COMPANY, INC. GROUP MEDICAL PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01First time form 5500 has been submittedYes
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number31000047
Policy instance 1
Insurance contract or identification number31000047
Number of Individuals Covered48
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $184,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number31000047
Policy instance 1
Insurance contract or identification number31000047
Number of Individuals Covered54
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $191,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number31000047
Policy instance 1
Insurance contract or identification number31000047
Number of Individuals Covered53
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $160,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number31000047
Policy instance 1
Insurance contract or identification number31000047
Number of Individuals Covered77
Insurance policy start date2020-04-01
Insurance policy end date2020-06-30
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $49,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number31000047
Policy instance 1
Insurance contract or identification number31000047
Number of Individuals Covered75
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $205,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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