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KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 401k Plan overview

Plan NameKAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN
Plan identification number 001

KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

KAYAKU ADVANCED MATERIALS, INC. has sponsored the creation of one or more 401k plans.

Company Name:KAYAKU ADVANCED MATERIALS, INC.
Employer identification number (EIN):043191900
NAIC Classification:325900
NAIC Description:Other Chemical Product and Preparation Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012020-01-01
0012020-01-01
0012020-01-01
0012019-01-01
0012018-01-01JEREMIAH J. COLE, JR.2019-07-23 JEREMIAH J. COLE, JR.2019-07-23
0012017-01-01JEREMIAH J. COLE, JR.2018-10-04 JEREMIAH J. COLE, JR.2018-10-04
0012016-01-01JEREMIAH J. COLE, JR.2017-10-05 JEREMIAH J. COLE, JR.2017-10-05
0012015-01-01JEREMIAH J. COLE, JR.2016-06-08 JEREMIAH J. COLE, JR.2016-06-08
0012014-01-01JEREMIAH J. COLE, JR.2015-07-13 JEREMIAH J. COLE, JR.2015-07-13
0012013-01-01JEREMIAH J. COLE, JR.2014-06-30 JEREMIAH J. COLE, JR.2014-06-30
0012012-01-01JEREMIAH J. COLE, JR.2013-10-10 JEREMIAH J. COLE, JR.2013-10-10
0012011-01-01JEREMIAH J. COLE, JR.2012-09-28 JEREMIAH J. COLE, JR.2012-09-28
0012010-01-01JEREMIAH J. COLE, JR.2011-07-05 JEREMIAH J. COLE, JR.2011-07-05

Plan Statistics for KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN

401k plan membership statisitcs for KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN

Measure Date Value
2022: KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01140
Total number of active participants reported on line 7a of the Form 55002022-01-01109
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-0136
Total of all active and inactive participants2022-01-01147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01147
Number of participants with account balances2022-01-01111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01138
Total number of active participants reported on line 7a of the Form 55002021-01-01103
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0138
Total of all active and inactive participants2021-01-01141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01141
Number of participants with account balances2021-01-01110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01132
Total number of active participants reported on line 7a of the Form 55002020-01-01100
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0138
Total of all active and inactive participants2020-01-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01138
Number of participants with account balances2020-01-01110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01125
Total number of active participants reported on line 7a of the Form 55002019-01-0195
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0136
Total of all active and inactive participants2019-01-01131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01131
Number of participants with account balances2019-01-01108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010

Financial Data on KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN

Measure Date Value
2022 : KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-1,145,892
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,654,713
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,647,687
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$886,198
Value of total assets at end of year2022-12-31$9,171,992
Value of total assets at beginning of year2022-12-31$11,972,597
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$7,026
Total interest from all sources2022-12-31$4,543
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$615,124
Participant contributions at end of year2022-12-31$118,894
Participant contributions at beginning of year2022-12-31$45,041
Assets. Other investments not covered elsewhere at end of year2022-12-31$336,274
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$403,613
Other income not declared elsewhere2022-12-31$-62,012
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-2,800,605
Value of net assets at end of year (total assets less liabilities)2022-12-31$9,171,992
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$11,972,597
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$7,026
Value of interest in pooled separate accounts at end of year2022-12-31$7,894,631
Value of interest in pooled separate accounts at beginning of year2022-12-31$10,643,574
Interest on participant loans2022-12-31$4,543
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$551,119
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$624,341
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,974,621
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$271,074
Employer contributions (assets) at end of year2022-12-31$271,074
Employer contributions (assets) at beginning of year2022-12-31$256,028
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,647,687
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31GRAY, GRAY & GRAY, LLP
Accountancy firm EIN2022-12-31042088368
2021 : KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$2,485,588
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,491,956
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,485,452
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$973,430
Value of total assets at end of year2021-12-31$11,972,597
Value of total assets at beginning of year2021-12-31$10,978,965
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$6,504
Total interest from all sources2021-12-31$2,597
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$694,744
Participant contributions at end of year2021-12-31$45,041
Participant contributions at beginning of year2021-12-31$60,955
Assets. Other investments not covered elsewhere at end of year2021-12-31$403,613
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$777,007
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$20,855
Other income not declared elsewhere2021-12-31$73,879
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$993,632
Value of net assets at end of year (total assets less liabilities)2021-12-31$11,972,597
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$10,978,965
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$6,504
Value of interest in pooled separate accounts at end of year2021-12-31$10,643,574
Value of interest in pooled separate accounts at beginning of year2021-12-31$9,340,937
Interest on participant loans2021-12-31$2,597
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$624,341
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$545,600
Net investment gain/loss from pooled separate accounts2021-12-31$1,435,682
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$257,831
Employer contributions (assets) at end of year2021-12-31$256,028
Employer contributions (assets) at beginning of year2021-12-31$254,466
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,485,452
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31EOS ACCOUNTANTS LLP
Accountancy firm EIN2021-12-31223642644
2020 : KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$2,695,256
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$902,226
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$891,595
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,304,258
Value of total assets at end of year2020-12-31$10,978,965
Value of total assets at beginning of year2020-12-31$9,185,935
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$10,631
Total interest from all sources2020-12-31$4,071
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$640,938
Participant contributions at end of year2020-12-31$60,955
Participant contributions at beginning of year2020-12-31$90,569
Assets. Other investments not covered elsewhere at end of year2020-12-31$777,007
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$723,254
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$408,854
Other income not declared elsewhere2020-12-31$63,934
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,793,030
Value of net assets at end of year (total assets less liabilities)2020-12-31$10,978,965
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$9,185,935
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$10,631
Value of interest in pooled separate accounts at end of year2020-12-31$9,340,937
Value of interest in pooled separate accounts at beginning of year2020-12-31$7,638,060
Interest on participant loans2020-12-31$4,071
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$545,600
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$486,206
Net investment gain/loss from pooled separate accounts2020-12-31$1,322,993
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$254,466
Employer contributions (assets) at end of year2020-12-31$254,466
Employer contributions (assets) at beginning of year2020-12-31$247,846
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$891,595
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31EOS ACCOUNTANTS LLP
Accountancy firm EIN2020-12-31223642644
2019 : KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$2,470,831
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$687,808
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$677,326
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$883,635
Value of total assets at end of year2019-12-31$9,185,935
Value of total assets at beginning of year2019-12-31$7,402,912
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$10,482
Total interest from all sources2019-12-31$6,794
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$635,789
Participant contributions at end of year2019-12-31$90,569
Participant contributions at beginning of year2019-12-31$162,970
Assets. Other investments not covered elsewhere at end of year2019-12-31$723,254
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$608,479
Other income not declared elsewhere2019-12-31$127,073
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,783,023
Value of net assets at end of year (total assets less liabilities)2019-12-31$9,185,935
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$7,402,912
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$10,482
Value of interest in pooled separate accounts at end of year2019-12-31$7,638,060
Value of interest in pooled separate accounts at beginning of year2019-12-31$5,931,039
Interest on participant loans2019-12-31$6,794
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$486,206
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$458,791
Net investment gain/loss from pooled separate accounts2019-12-31$1,453,329
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$247,846
Employer contributions (assets) at end of year2019-12-31$247,846
Employer contributions (assets) at beginning of year2019-12-31$241,633
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$677,326
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31EOS ACCOUNTANTS LLP
Accountancy firm EIN2019-12-31223642644

Form 5500 Responses for KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN

2022: KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: KAYAKU ADVANCED MATERIALS, INC. 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number93936
Policy instance 1
Insurance contract or identification number93936
Number of Individuals Covered2
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $870
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $435
Insurance broker organization code?4
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number816768
Policy instance 2
Insurance contract or identification number816768
Number of Individuals Covered105
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $22,006
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,006
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number93936
Policy instance 1
Insurance contract or identification number93936
Number of Individuals Covered2
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $972
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $486
Insurance broker organization code?4
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number816768
Policy instance 2
Insurance contract or identification number816768
Number of Individuals Covered105
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $26,686
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,686
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number816768
Policy instance 1
Insurance contract or identification number816768
Number of Individuals Covered106
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $27,264
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,180
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number816768
Policy instance 1
Insurance contract or identification number816768
Number of Individuals Covered106
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $24,785
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,356
Insurance broker organization code?3

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