401k Plan data: VISION INSURANCE plan

VISION INSURANCE 401k Plan overview

Plan Name	VISION INSURANCE
Plan identification number	505

VISION INSURANCE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

MOLDED RUBBER AND PLASTIC CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: MOLDED RUBBER AND PLASTIC CORPORATION

Employer identification number (EIN): 390504940

NAIC Classification: 326200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VISION INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2023-01-01
505 2022-01-01

Plan Statistics for VISION INSURANCE

401k plan membership statisitcs for VISION INSURANCE

Measure Date Value
2023: VISION INSURANCE 2023 401k membership
Total participants, beginning-of-year 2023-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 117
Total of all active and inactive participants 2023-01-01 117
Total participants 2023-01-01 117
2022: VISION INSURANCE 2022 401k membership
Total participants, beginning-of-year 2022-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 113
Total of all active and inactive participants 2022-01-01 113
Total participants 2022-01-01 113

Measure	Date	Value
2023: VISION INSURANCE 2023 401k membership
Total participants, beginning-of-year	2023-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	117
Total of all active and inactive participants	2023-01-01	117
Total participants	2023-01-01	117
2022: VISION INSURANCE 2022 401k membership
Total participants, beginning-of-year	2022-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	113
Total of all active and inactive participants	2022-01-01	113
Total participants	2022-01-01	113

Form 5500 Responses for VISION INSURANCE

2023: VISION INSURANCE 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: VISION INSURANCE 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	First time form 5500 has been submitted	Yes
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0932379

Policy instance

Insurance contract or identification number	0932379
Number of Individuals Covered	117
Insurance policy start date	2023-10-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $219
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $2,194
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

404480

Policy instance

Insurance contract or identification number	404480
Number of Individuals Covered	117
Insurance policy start date	2023-01-01
Insurance policy end date	2023-09-30
Total amount of commissions paid to insurance broker	USD $957
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $8,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

754436

Policy instance

Insurance contract or identification number	754436
Number of Individuals Covered	113
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,441
Total amount of fees paid to insurance company	USD $1,441
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $14,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,441
Insurance broker organization code?	3

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Company Name:	MOLDED RUBBER AND PLASTIC CORPORATION
Employer identification number (EIN):	390504940
NAIC Classification:	326200