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EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN 401k Plan overview

Plan NameEMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN
Plan identification number 501

EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

EMPLOYMENT COMMONS LCA has sponsored the creation of one or more 401k plans.

Company Name:EMPLOYMENT COMMONS LCA
Employer identification number (EIN):851138180
NAIC Classification:561110
NAIC Description:Office Administrative Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01EDDIE PASTORE2024-07-24
5012022-06-01EDDIE PASTORE2023-09-29

Plan Statistics for EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN

401k plan membership statisitcs for EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN

Measure Date Value
2023: EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01303
Total number of active participants reported on line 7a of the Form 55002023-01-01287
Number of retired or separated participants receiving benefits2023-01-014
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01291
Number of employers contributing to the scheme2023-01-010
2022: EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01100
Total number of active participants reported on line 7a of the Form 55002022-06-01401
Number of retired or separated participants receiving benefits2022-06-010
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-01401
Number of employers contributing to the scheme2022-06-010

Form 5500 Responses for EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN

2023: EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: EMPLOYMENT COMMONS LCA HEALTH & WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01First time form 5500 has been submittedYes
2022-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan funding arrangement – General assets of the sponsorYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1158391
Policy instance 1
Insurance contract or identification number1158391
Number of Individuals Covered486
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $17,618
Total amount of fees paid to insurance companyUSD $13,686
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $332,966
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 number1158391
Policy instance 1
Insurance contract or identification number1158391
Number of Individuals Covered484
Insurance policy start date2022-06-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,419
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $247,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,419
Amount paid for insurance broker fees0
Insurance broker organization code?3

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