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AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 401k Plan overview

Plan NameAUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN
Plan identification number 504

AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

AUTOMOBILE CLUB OF NEW YORK INC has sponsored the creation of one or more 401k plans.

Company Name:AUTOMOBILE CLUB OF NEW YORK INC
Employer identification number (EIN):130458080
NAIC Classification:524290

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042014-04-01ROBERT WALTERS
5042013-04-01DENNIS CROSSLEY
5042012-04-01DENNIS CROSSLEY
5042011-04-01DENNIS CROSSLEY
5042009-04-01DENNIS CROSSLEY
5042009-04-01 DENNIS CROSSLEY2010-10-15

Plan Statistics for AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN

401k plan membership statisitcs for AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN

Measure Date Value
2014: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01523
Total number of active participants reported on line 7a of the Form 55002014-04-010
Total of all active and inactive participants2014-04-010
Total participants2014-04-010
2013: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01533
Total number of active participants reported on line 7a of the Form 55002013-04-01520
Number of retired or separated participants receiving benefits2013-04-013
Total of all active and inactive participants2013-04-01523
Total participants2013-04-01523
2012: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01514
Total number of active participants reported on line 7a of the Form 55002012-04-01530
Number of retired or separated participants receiving benefits2012-04-013
Total of all active and inactive participants2012-04-01533
Total participants2012-04-01533
2011: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01474
Total number of active participants reported on line 7a of the Form 55002011-04-01511
Number of retired or separated participants receiving benefits2011-04-013
Total of all active and inactive participants2011-04-01514
Total participants2011-04-01514
2009: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01499
Total number of active participants reported on line 7a of the Form 55002009-04-01479
Number of retired or separated participants receiving benefits2009-04-013
Total of all active and inactive participants2009-04-01482
Total participants2009-04-01482

Form 5500 Responses for AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN

2014: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingYes
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes
2009: AUTOMOBILE CLUB OF NEW YORK INC GROUP LIFE AD&D & DBL PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedYes
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number645052D
Policy instance 1
Insurance contract or identification number645052D
Number of Individuals Covered648
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $3,188
Are there contracts with allocated funds for individual policies?No
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
Other welfare benefits providedSTATE DISABILITY
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 $3,188
Insurance broker organization code?3
Insurance broker nameALLIANT INSURANCE SVCS INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number648946
Policy instance 1
Insurance contract or identification number648946
Number of Individuals Covered523
Insurance policy start date2013-04-01
Insurance policy end date2013-08-31
Are there contracts with allocated funds for individual policies?No
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
Other welfare benefits providedSTATE DISABILITY
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number645052D
Policy instance 2
Insurance contract or identification number645052D
Number of Individuals Covered523
Insurance policy start date2013-09-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $2,472
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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
Other welfare benefits providedSTATE DISABILITY
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 $2,472
Insurance broker organization code?3
Insurance broker nameALLIANT INSURANCE SERVICES INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number648946
Policy instance 1
Insurance contract or identification number648946
Number of Individuals Covered533
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number02937
Policy instance 1
Insurance contract or identification number02937
Number of Individuals Covered491
Insurance policy start date2011-04-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $9,178
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number648946
Policy instance 2
Insurance contract or identification number648946
Number of Individuals Covered636
Insurance policy start date2011-09-01
Insurance policy end date2012-03-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Other welfare benefits providedSTATE DISABILITY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number02937
Policy instance 1
Insurance contract or identification number02937
Number of Individuals Covered470
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $24,626
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $189,005
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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