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BASIC LIFE INSURANCE AND AD&D 401k Plan overview

Plan NameBASIC LIFE INSURANCE AND AD&D
Plan identification number 502

BASIC LIFE INSURANCE AND AD&D Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

AFC SPECIALTY COATINGS GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:AFC SPECIALTY COATINGS GROUP, INC.
Employer identification number (EIN):363580228
NAIC Classification:314000
NAIC Description: Textile Product Mills

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BASIC LIFE INSURANCE AND AD&D

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-09-01TODD OUELLETTE2024-06-11
5022021-09-01TODD OUELLETTE2024-08-28
5022020-09-01
5022019-09-01
5022018-09-01
5022017-09-01JANELLE LEDGERWOOD JANELLE LEDGERWOOD2019-02-12
5022016-09-01JANELLE LEDGERWOOD
5022015-09-01JANELLE LEDGERWOOD
5022014-09-01JANELLE LEDGERWOOD

Plan Statistics for BASIC LIFE INSURANCE AND AD&D

401k plan membership statisitcs for BASIC LIFE INSURANCE AND AD&D

Measure Date Value
2022: BASIC LIFE INSURANCE AND AD&D 2022 401k membership
Total participants, beginning-of-year2022-09-01134
Total number of active participants reported on line 7a of the Form 55002022-09-010
Number of retired or separated participants receiving benefits2022-09-010
Number of other retired or separated participants entitled to future benefits2022-09-010
Total of all active and inactive participants2022-09-010
2021: BASIC LIFE INSURANCE AND AD&D 2021 401k membership
Total participants, beginning-of-year2021-09-01137
Total number of active participants reported on line 7a of the Form 55002021-09-01138
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01138
2020: BASIC LIFE INSURANCE AND AD&D 2020 401k membership
Total participants, beginning-of-year2020-09-01150
Total number of active participants reported on line 7a of the Form 55002020-09-01137
Number of retired or separated participants receiving benefits2020-09-010
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01137
Total participants2020-09-01137
Number of employers contributing to the scheme2020-09-010
2019: BASIC LIFE INSURANCE AND AD&D 2019 401k membership
Total participants, beginning-of-year2019-09-01116
Total number of active participants reported on line 7a of the Form 55002019-09-01103
Number of retired or separated participants receiving benefits2019-09-010
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-01103
Total participants2019-09-01103
Number of employers contributing to the scheme2019-09-010
2018: BASIC LIFE INSURANCE AND AD&D 2018 401k membership
Total participants, beginning-of-year2018-09-01139
Total number of active participants reported on line 7a of the Form 55002018-09-01116
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-09-010
Total participants2018-09-01116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-09-010
Number of employers contributing to the scheme2018-09-010
2017: BASIC LIFE INSURANCE AND AD&D 2017 401k membership
Total participants, beginning-of-year2017-09-01141
Total number of active participants reported on line 7a of the Form 55002017-09-01138
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-09-010
Total participants2017-09-01138
2016: BASIC LIFE INSURANCE AND AD&D 2016 401k membership
Total participants, beginning-of-year2016-09-01138
Total number of active participants reported on line 7a of the Form 55002016-09-01143
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-09-010
Total participants2016-09-01143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-09-010
2015: BASIC LIFE INSURANCE AND AD&D 2015 401k membership
Total participants, beginning-of-year2015-09-01118
Total number of active participants reported on line 7a of the Form 55002015-09-01126
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-01126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-09-010
Total participants2015-09-01126
Number of participants with account balances2015-09-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-09-010
Number of employers contributing to the scheme2015-09-010
2014: BASIC LIFE INSURANCE AND AD&D 2014 401k membership
Total participants, beginning-of-year2014-09-01103
Total number of active participants reported on line 7a of the Form 55002014-09-01118
Number of retired or separated participants receiving benefits2014-09-010
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-01118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-09-010
Total participants2014-09-01118
Number of participants with account balances2014-09-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-09-010
Number of employers contributing to the scheme2014-09-010

Form 5500 Responses for BASIC LIFE INSURANCE AND AD&D

2022: BASIC LIFE INSURANCE AND AD&D 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01Submission has been amendedNo
2022-09-01This submission is the final filingYes
2022-09-01This return/report is a short plan year return/report (less than 12 months)No
2022-09-01Plan is a collectively bargained planNo
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan benefit arrangement – InsuranceYes
2021: BASIC LIFE INSURANCE AND AD&D 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planNo
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: BASIC LIFE INSURANCE AND AD&D 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: BASIC LIFE INSURANCE AND AD&D 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)No
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: BASIC LIFE INSURANCE AND AD&D 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: BASIC LIFE INSURANCE AND AD&D 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)No
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: BASIC LIFE INSURANCE AND AD&D 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01First time form 5500 has been submittedYes
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: BASIC LIFE INSURANCE AND AD&D 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01First time form 5500 has been submittedYes
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: BASIC LIFE INSURANCE AND AD&D 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01First time form 5500 has been submittedYes
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number209671
Policy instance 1
Insurance contract or identification number209671
Number of Individuals Covered128
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $2,636
Total amount of fees paid to insurance companyUSD $141
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $7,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,636
Insurance broker organization code?3
Amount paid for insurance broker fees141
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number209671
Policy instance 1
Insurance contract or identification number209671
Number of Individuals Covered138
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $9,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number209671
Policy instance 1
Insurance contract or identification number209671
Number of Individuals Covered137
Insurance policy start date2020-09-01
Insurance policy end date2021-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $7,417
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number209671
Policy instance 1
Insurance contract or identification number209671
Number of Individuals Covered103
Insurance policy start date2019-09-01
Insurance policy end date2020-09-01
Total amount of commissions paid to insurance brokerUSD $2,005
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $42,993
Commission paid to Insurance BrokerUSD $2,005
Amount paid for insurance broker fees0
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number000000209671
Policy instance 1
Insurance contract or identification number000000209671
Number of Individuals Covered116
Insurance policy start date2018-09-01
Insurance policy end date2019-09-01
Total amount of commissions paid to insurance brokerUSD $707
Total amount of fees paid to insurance companyUSD $0
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 $7,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $707
Amount paid for insurance broker fees0
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number209671
Policy instance 1
Insurance contract or identification number209671
Number of Individuals Covered138
Insurance policy start date2017-09-01
Insurance policy end date2018-09-01
Total amount of commissions paid to insurance brokerUSD $6,034
Total amount of fees paid to insurance companyUSD $55,846
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $55,846
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number209671
Policy instance 1
Insurance contract or identification number209671
Number of Individuals Covered126
Insurance policy start date2015-09-01
Insurance policy end date2016-09-01
Total amount of commissions paid to insurance brokerUSD $4,814
Total amount of fees paid to insurance companyUSD $304
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,814
Amount paid for insurance broker fees304
Insurance broker nameMESIROW INSURANCE SERVICES INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number209671
Policy instance 1
Insurance contract or identification number209671
Number of Individuals Covered118
Insurance policy start date2014-09-01
Insurance policy end date2015-09-01
Total amount of commissions paid to insurance brokerUSD $4,597
Total amount of fees paid to insurance companyUSD $288
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,597
Amount paid for insurance broker fees288
Insurance broker nameMESIROW INSURANCE SERVICES INC

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