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THE WILSON COMBAT CAFETERIA PLAN 401k Plan overview

Plan NameTHE WILSON COMBAT CAFETERIA PLAN
Plan identification number 501

THE WILSON COMBAT CAFETERIA PLAN Benefits

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

401k Sponsoring company profile

WILSONS GUN SHOP, INC. has sponsored the creation of one or more 401k plans.

Company Name:WILSONS GUN SHOP, INC.
Employer identification number (EIN):710569698
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE WILSON COMBAT CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-04-01DUANE WORMINGTON2024-08-28
5012022-04-01DUANE WORMINGTON2024-01-03
5012021-04-01DUANE WORMINGTON2022-07-07
5012020-04-01DUANE WORMINGTON2021-10-08
5012019-04-01DUANE WORMINGTON2020-11-16 DUANE WORMINGTON2020-11-16
5012019-04-01DUANE WORMINGTON2020-11-16 DUANE WORMINGTON2020-11-16
5012018-04-01DUANE WORMINGTON2019-10-24 DUANE WORMINGTON2019-10-24

Plan Statistics for THE WILSON COMBAT CAFETERIA PLAN

401k plan membership statisitcs for THE WILSON COMBAT CAFETERIA PLAN

Measure Date Value
2023: THE WILSON COMBAT CAFETERIA PLAN 2023 401k membership
Total participants, beginning-of-year2023-04-01214
Total number of active participants reported on line 7a of the Form 55002023-04-01205
Number of retired or separated participants receiving benefits2023-04-010
Number of other retired or separated participants entitled to future benefits2023-04-010
Total of all active and inactive participants2023-04-01205
Number of employers contributing to the scheme2023-04-010
2022: THE WILSON COMBAT CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01223
Total number of active participants reported on line 7a of the Form 55002022-04-01214
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01214
Number of employers contributing to the scheme2022-04-010
2021: THE WILSON COMBAT CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01201
Total number of active participants reported on line 7a of the Form 55002021-04-01223
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01223
Number of employers contributing to the scheme2021-04-010
2020: THE WILSON COMBAT CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01157
Total number of active participants reported on line 7a of the Form 55002020-04-01197
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 participants2020-04-01197
Number of employers contributing to the scheme2020-04-014
2019: THE WILSON COMBAT CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01122
Total number of active participants reported on line 7a of the Form 55002019-04-01115
Total of all active and inactive participants2019-04-01115
Total participants2019-04-01115
2018: THE WILSON COMBAT CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01109
Total number of active participants reported on line 7a of the Form 55002018-04-01122
Total of all active and inactive participants2018-04-01122
Total participants2018-04-01122

Form 5500 Responses for THE WILSON COMBAT CAFETERIA PLAN

2023: THE WILSON COMBAT CAFETERIA PLAN 2023 form 5500 responses
2023-04-01Type of plan entitySingle employer plan
2023-04-01Plan funding arrangement – InsuranceYes
2023-04-01Plan benefit arrangement – InsuranceYes
2022: THE WILSON COMBAT CAFETERIA PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: THE WILSON COMBAT CAFETERIA PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: THE WILSON COMBAT CAFETERIA PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: THE WILSON COMBAT CAFETERIA PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: THE WILSON COMBAT CAFETERIA PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number635988
Policy instance 4
Insurance contract or identification number635988
Number of Individuals Covered173
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,321,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number573570
Policy instance 3
Insurance contract or identification number573570
Number of Individuals Covered78
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $6,995
Total amount of fees paid to insurance companyUSD $1,273
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $25,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number9186
Policy instance 2
Insurance contract or identification number9186
Number of Individuals Covered239
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $6,725
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1126973
Policy instance 1
Insurance contract or identification number1126973
Number of Individuals Covered292
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $12,679
Total amount of fees paid to insurance companyUSD $6,427
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $77,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1126973
Policy instance 1
Insurance contract or identification number1126973
Number of Individuals Covered302
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $10,958
Total amount of fees paid to insurance companyUSD $2,156
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $79,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,958
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number9186
Policy instance 2
Insurance contract or identification number9186
Number of Individuals Covered230
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $7,119
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,119
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number573570
Policy instance 3
Insurance contract or identification number573570
Number of Individuals Covered87
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $7,099
Total amount of fees paid to insurance companyUSD $1,300
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $30,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,038
Amount paid for insurance broker fees1300
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number635988
Policy instance 4
Insurance contract or identification number635988
Number of Individuals Covered173
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $342,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number573570
Policy instance 4
Insurance contract or identification number573570
Number of Individuals Covered86
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $6,187
Total amount of fees paid to insurance companyUSD $2,081
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $26,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,134
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number9186
Policy instance 3
Insurance contract or identification number9186
Number of Individuals Covered219
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $6,505
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,505
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1126973
Policy instance 2
Insurance contract or identification number1126973
Number of Individuals Covered309
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $10,672
Total amount of fees paid to insurance companyUSD $949
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $72,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,672
Amount paid for insurance broker fees949
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 )
Policy contract number53546
Policy instance 1
Insurance contract or identification number53546
Number of Individuals Covered181
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $864,171
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number573570
Policy instance 4
Insurance contract or identification number573570
Number of Individuals Covered85
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $5,878
Total amount of fees paid to insurance companyUSD $995
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $24,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,702
Amount paid for insurance broker fees995
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number9186
Policy instance 3
Insurance contract or identification number9186
Number of Individuals Covered175
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $4,680
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,680
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1126973
Policy instance 2
Insurance contract or identification number1126973
Number of Individuals Covered274
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $7,650
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $55,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,650
Amount paid for insurance broker fees0
Insurance broker organization code?3
QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 )
Policy contract number53546
Policy instance 1
Insurance contract or identification number53546
Number of Individuals Covered148
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $646,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000009186
Policy instance 2
Insurance contract or identification number000009186
Number of Individuals Covered152
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $3,586
Dental Insurance Welfare BenefitYes
Commission paid to Insurance BrokerUSD $294
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number12271964
Policy instance 3
Insurance contract or identification number12271964
Number of Individuals Covered88
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $969
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $250
Insurance broker organization code?3
QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 )
Policy contract number53546
Policy instance 1
Insurance contract or identification number53546
Number of Individuals Covered172
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $12,411
Health Insurance Welfare BenefitYes
Commission paid to Insurance BrokerUSD $10,957
Insurance broker organization code?3
QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 )
Policy contract number53546
Policy instance 1
Insurance contract or identification number53546
Number of Individuals Covered178
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $14,124
Health Insurance Welfare BenefitYes
Commission paid to Insurance BrokerUSD $14,124
Insurance broker organization code?5
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000009186
Policy instance 2
Insurance contract or identification number000009186
Number of Individuals Covered153
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $3,547
Dental Insurance Welfare BenefitYes
Commission paid to Insurance BrokerUSD $3,547
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number12271964
Policy instance 3
Insurance contract or identification number12271964
Number of Individuals Covered87
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $879
Vision Insurance Welfare BenefitYes
Commission paid to Insurance BrokerUSD $879

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