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MEDICAL, DENTAL & VISION PLAN 401k Plan overview

Plan NameMEDICAL, DENTAL & VISION PLAN
Plan identification number 503

MEDICAL, DENTAL & VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:THOMBERT, INC.
Employer identification number (EIN):420670188
NAIC Classification:326100

Additional information about THOMBERT, INC.

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 1949-11-22
Company Identification Number: 040283
Legal Registered Office Address: 316 E 7TH ST N

NEWTON
United States of America (USA)
50208

More information about THOMBERT, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL, DENTAL & VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-09-01TERRY FEHR2024-06-06 TERRY FEHR2024-06-06
5032021-09-01TERRY FEHR2023-01-20 TERRY FEHR2023-01-20
5032020-09-01TERRY FEHR2022-06-07 TERRY FEHR2022-06-07
5032019-09-01TERRY FEHR2022-03-14 TERRY FEHR2022-03-14
5032018-09-01TERRY FEHR2022-03-14 TERRY FEHR2022-03-14
5032016-09-01TERRY FEHR2022-03-09 TERRY FEHR2022-03-09

Plan Statistics for MEDICAL, DENTAL & VISION PLAN

401k plan membership statisitcs for MEDICAL, DENTAL & VISION PLAN

Measure Date Value
2022: MEDICAL, DENTAL & VISION PLAN 2022 401k membership
Total participants, beginning-of-year2022-09-01119
Total number of active participants reported on line 7a of the Form 55002022-09-0151
Total of all active and inactive participants2022-09-0151
2021: MEDICAL, DENTAL & VISION PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01110
Total number of active participants reported on line 7a of the Form 55002021-09-01119
Total of all active and inactive participants2021-09-01119
2020: MEDICAL, DENTAL & VISION PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01104
Total number of active participants reported on line 7a of the Form 55002020-09-01110
Total of all active and inactive participants2020-09-01110
2019: MEDICAL, DENTAL & VISION PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01105
Total number of active participants reported on line 7a of the Form 55002019-09-01104
Total of all active and inactive participants2019-09-01104
2018: MEDICAL, DENTAL & VISION PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01102
Total number of active participants reported on line 7a of the Form 55002018-09-01105
Total of all active and inactive participants2018-09-01105
2016: MEDICAL, DENTAL & VISION PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01100
Total number of active participants reported on line 7a of the Form 55002016-09-0196
Total of all active and inactive participants2016-09-0196

Form 5500 Responses for MEDICAL, DENTAL & VISION PLAN

2022: MEDICAL, DENTAL & VISION PLAN 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan benefit arrangement – InsuranceYes
2021: MEDICAL, DENTAL & VISION PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: MEDICAL, DENTAL & VISION PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: MEDICAL, DENTAL & VISION PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: MEDICAL, DENTAL & VISION PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2016: MEDICAL, DENTAL & VISION PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number417005411852
Policy instance 2
Insurance contract or identification number417005411852
Insurance policy start date2022-05-01
Insurance policy end date2023-05-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $11,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417007411852
Policy instance 1
Insurance contract or identification number417007411852
Number of Individuals Covered109
Insurance policy start date2022-05-01
Insurance policy end date2023-05-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $458,464
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 number417005411852
Policy instance 2
Insurance contract or identification number417005411852
Insurance policy start date2021-05-01
Insurance policy end date2022-05-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $11,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417007411852
Policy instance 1
Insurance contract or identification number417007411852
Number of Individuals Covered114
Insurance policy start date2021-05-01
Insurance policy end date2022-05-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $430,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417007411852
Policy instance 1
Insurance contract or identification number417007411852
Number of Individuals Covered103
Insurance policy start date2020-05-01
Insurance policy end date2021-05-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $395,847
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 number417005411852
Policy instance 2
Insurance contract or identification number417005411852
Insurance policy start date2020-05-01
Insurance policy end date2021-05-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $11,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417007411852
Policy instance 1
Insurance contract or identification number417007411852
Number of Individuals Covered100
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $312,578
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 number417005411852
Policy instance 2
Insurance contract or identification number417005411852
Number of Individuals Covered100
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $10,943
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 number417005411852
Policy instance 2
Insurance contract or identification number417005411852
Number of Individuals Covered100
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $11,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38776 )
Policy contract number417004411852
Policy instance 1
Insurance contract or identification number417004411852
Number of Individuals Covered100
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $269,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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