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HEALTH BENEFIT PLAN FOR WOLVERINE BUILDING INC. 401k Plan overview

Plan NameHEALTH BENEFIT PLAN FOR WOLVERINE BUILDING INC.
Plan identification number 501

HEALTH BENEFIT PLAN FOR WOLVERINE BUILDING INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

WOLVERINE BUILDING, INC. has sponsored the creation of one or more 401k plans.

Company Name:WOLVERINE BUILDING, INC.
Employer identification number (EIN):381600177
NAIC Classification:236110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH BENEFIT PLAN FOR WOLVERINE BUILDING INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01

Plan Statistics for HEALTH BENEFIT PLAN FOR WOLVERINE BUILDING INC.

401k plan membership statisitcs for HEALTH BENEFIT PLAN FOR WOLVERINE BUILDING INC.

Measure Date Value
2017: HEALTH BENEFIT PLAN FOR WOLVERINE BUILDING INC. 2017 401k membership
Total participants, beginning-of-year2017-01-01100
Total number of active participants reported on line 7a of the Form 55002017-01-01106
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01107

Form 5500 Responses for HEALTH BENEFIT PLAN FOR WOLVERINE BUILDING INC.

2017: HEALTH BENEFIT PLAN FOR WOLVERINE BUILDING INC. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number144304
Policy instance 1
Insurance contract or identification number144304
Number of Individuals Covered126
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,128
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,128
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLIGHTHOUSE GROUP INSURANCE
ASR CORPORATION (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberG-1030
Policy instance 2
Insurance contract or identification numberG-1030
Number of Individuals Covered87
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,768
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,768
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameASR HEALTH BENEFITS

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