401k Plan data: EPTAM PLASTIC LTD LIFE INSURANCE PLAN plan

EPTAM PLASTIC LTD LIFE INSURANCE PLAN 401k Plan overview

Plan Name	EPTAM PLASTIC LTD LIFE INSURANCE PLAN
Plan identification number	506

EPTAM PLASTIC LTD LIFE INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

EPTAM PLASTICS LTD has sponsored the creation of one or more 401k plans.

Company Name: EPTAM PLASTICS LTD

Employer identification number (EIN): 020363107

NAIC Classification: 326100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EPTAM PLASTIC LTD LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2020-12-01 PATRICK HILL 2021-07-29
506 2019-12-01 PATRICK N. HILL 2021-08-18
506 2018-12-01 PATRICK N HILL 2020-08-11 PATRICK N HILL 2020-08-11
506 2017-12-01 THOMAS W. MANTER 2019-05-24 THOMAS W. MANTER 2019-05-24
506 2017-12-01 PATRICK N. HILL 2020-09-11
506 2016-12-01
506 2015-12-01
506 2014-12-01
506 2013-12-01
506 2012-12-01 TOM MANTER
506 2011-12-01 TOM MANTER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
506	2020-12-01	PATRICK HILL	2021-07-29
506	2019-12-01	PATRICK N. HILL	2021-08-18
506	2018-12-01	PATRICK N HILL	2020-08-11	PATRICK N HILL	2020-08-11
506	2017-12-01	THOMAS W. MANTER	2019-05-24	THOMAS W. MANTER	2019-05-24
506	2017-12-01	PATRICK N. HILL	2020-09-11
506	2016-12-01
506	2015-12-01
506	2014-12-01
506	2013-12-01
506	2012-12-01	TOM MANTER
506	2011-12-01	TOM MANTER

Plan Statistics for EPTAM PLASTIC LTD LIFE INSURANCE PLAN

401k plan membership statisitcs for EPTAM PLASTIC LTD LIFE INSURANCE PLAN

Measure Date Value
2020: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-12-01 165
Total number of active participants reported on line 7a of the Form 5500 2020-12-01 0
Number of retired or separated participants receiving benefits 2020-12-01 0
Number of other retired or separated participants entitled to future benefits 2020-12-01 0
Total of all active and inactive participants 2020-12-01 0
Number of employers contributing to the scheme 2020-12-01 0
2019: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-12-01 149
Total number of active participants reported on line 7a of the Form 5500 2019-12-01 214
Number of retired or separated participants receiving benefits 2019-12-01 0
Number of other retired or separated participants entitled to future benefits 2019-12-01 0
Total of all active and inactive participants 2019-12-01 214
Number of employers contributing to the scheme 2019-12-01 0
2018: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-12-01 165
Total number of active participants reported on line 7a of the Form 5500 2018-12-01 149
Total of all active and inactive participants 2018-12-01 149
2017: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-12-01 134
Number of other retired or separated participants entitled to future benefits 2017-12-01 165
Total of all active and inactive participants 2017-12-01 165
Total number of active participants reported on line 7a of the Form 5500 2017-12-01 165
Number of retired or separated participants receiving benefits 2017-12-01 0
Number of employers contributing to the scheme 2017-12-01 0
2016: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-12-01 120
Total number of active participants reported on line 7a of the Form 5500 2016-12-01 134
Total of all active and inactive participants 2016-12-01 134
2015: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-12-01 111
Total number of active participants reported on line 7a of the Form 5500 2015-12-01 120
Total of all active and inactive participants 2015-12-01 120
2014: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-12-01 103
Total number of active participants reported on line 7a of the Form 5500 2014-12-01 111
Total of all active and inactive participants 2014-12-01 111
2013: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-12-01 106
Total number of active participants reported on line 7a of the Form 5500 2013-12-01 103
Total of all active and inactive participants 2013-12-01 103
2012: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-12-01 97
Total number of active participants reported on line 7a of the Form 5500 2012-12-01 106
Total of all active and inactive participants 2012-12-01 106
2011: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-12-01 102
Total number of active participants reported on line 7a of the Form 5500 2011-12-01 97
Total of all active and inactive participants 2011-12-01 97

Measure	Date	Value
2020: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-12-01	165
Total number of active participants reported on line 7a of the Form 5500	2020-12-01	0
Number of retired or separated participants receiving benefits	2020-12-01	0
Number of other retired or separated participants entitled to future benefits	2020-12-01	0
Total of all active and inactive participants	2020-12-01	0
Number of employers contributing to the scheme	2020-12-01	0
2019: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-12-01	149
Total number of active participants reported on line 7a of the Form 5500	2019-12-01	214
Number of retired or separated participants receiving benefits	2019-12-01	0
Number of other retired or separated participants entitled to future benefits	2019-12-01	0
Total of all active and inactive participants	2019-12-01	214
Number of employers contributing to the scheme	2019-12-01	0
2018: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-12-01	165
Total number of active participants reported on line 7a of the Form 5500	2018-12-01	149
Total of all active and inactive participants	2018-12-01	149
2017: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-12-01	134
Number of other retired or separated participants entitled to future benefits	2017-12-01	165
Total of all active and inactive participants	2017-12-01	165
Total number of active participants reported on line 7a of the Form 5500	2017-12-01	165
Number of retired or separated participants receiving benefits	2017-12-01	0
Number of employers contributing to the scheme	2017-12-01	0
2016: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-12-01	120
Total number of active participants reported on line 7a of the Form 5500	2016-12-01	134
Total of all active and inactive participants	2016-12-01	134
2015: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-12-01	111
Total number of active participants reported on line 7a of the Form 5500	2015-12-01	120
Total of all active and inactive participants	2015-12-01	120
2014: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-12-01	103
Total number of active participants reported on line 7a of the Form 5500	2014-12-01	111
Total of all active and inactive participants	2014-12-01	111
2013: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-12-01	106
Total number of active participants reported on line 7a of the Form 5500	2013-12-01	103
Total of all active and inactive participants	2013-12-01	103
2012: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-12-01	97
Total number of active participants reported on line 7a of the Form 5500	2012-12-01	106
Total of all active and inactive participants	2012-12-01	106
2011: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-12-01	102
Total number of active participants reported on line 7a of the Form 5500	2011-12-01	97
Total of all active and inactive participants	2011-12-01	97

Form 5500 Responses for EPTAM PLASTIC LTD LIFE INSURANCE PLAN

2020: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2020 form 5500 responses
2020-12-01	Type of plan entity	Single employer plan
2020-12-01	This submission is the final filing	Yes
2020-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-12-01	Plan funding arrangement – Insurance	Yes
2020-12-01	Plan benefit arrangement – Insurance	Yes
2019: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2019 form 5500 responses
2019-12-01	Type of plan entity	Single employer plan
2019-12-01	Plan funding arrangement – Insurance	Yes
2019-12-01	Plan benefit arrangement – Insurance	Yes
2018: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2018 form 5500 responses
2018-12-01	Type of plan entity	Single employer plan
2018-12-01	Plan funding arrangement – Insurance	Yes
2018-12-01	Plan benefit arrangement – Insurance	Yes
2017: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2017 form 5500 responses
2017-12-01	Type of plan entity	Single employer plan
2017-12-01	Submission has been amended	Yes
2017-12-01	Plan funding arrangement – Insurance	Yes
2017-12-01	Plan benefit arrangement – Insurance	Yes
2016: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2016 form 5500 responses
2016-12-01	Type of plan entity	Single employer plan
2016-12-01	Plan funding arrangement – Insurance	Yes
2016-12-01	Plan benefit arrangement – Insurance	Yes
2015: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2015 form 5500 responses
2015-12-01	Type of plan entity	Single employer plan
2015-12-01	Plan funding arrangement – Insurance	Yes
2015-12-01	Plan benefit arrangement – Insurance	Yes
2014: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2014 form 5500 responses
2014-12-01	Type of plan entity	Single employer plan
2014-12-01	Plan funding arrangement – Insurance	Yes
2014-12-01	Plan benefit arrangement – Insurance	Yes
2013: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2013 form 5500 responses
2013-12-01	Type of plan entity	Single employer plan
2013-12-01	Plan funding arrangement – Insurance	Yes
2013-12-01	Plan benefit arrangement – Insurance	Yes
2012: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2012 form 5500 responses
2012-12-01	Type of plan entity	Single employer plan
2012-12-01	Plan funding arrangement – Insurance	Yes
2012-12-01	Plan benefit arrangement – Insurance	Yes
2011: EPTAM PLASTIC LTD LIFE INSURANCE PLAN 2011 form 5500 responses
2011-12-01	Type of plan entity	Single employer plan
2011-12-01	First time form 5500 has been submitted	Yes
2011-12-01	Plan funding arrangement – Insurance	Yes
2011-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

940

Policy instance

Insurance contract or identification number	940
Number of Individuals Covered	217
Insurance policy start date	2020-12-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,134
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $8,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,134
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

940

Policy instance

Insurance contract or identification number	940
Number of Individuals Covered	214
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $6,841
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $88,987
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $6,841
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

000940

Policy instance

Insurance contract or identification number	000940
Number of Individuals Covered	172
Insurance policy start date	2018-12-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $8,651
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $75,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,651
Insurance broker organization code?	3

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

000940

Policy instance

Insurance contract or identification number	000940
Number of Individuals Covered	165
Insurance policy start date	2017-12-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $8,773
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $64,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	EPTAM PLASTICS LTD
Employer identification number (EIN):	020363107
NAIC Classification:	326100