401k Plan data: HITACHI RAIL USA INC. WELFARE BENEFIT PLAN plan

HITACHI RAIL USA INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	HITACHI RAIL USA INC. WELFARE BENEFIT PLAN
Plan identification number	501

HITACHI RAIL USA INC. WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare 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) Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

HITACHI RAIL USA INC has sponsored the creation of one or more 401k plans.

Company Name: HITACHI RAIL USA INC

Employer identification number (EIN): 133093379

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Additional information about HITACHI RAIL USA INC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 0927115

More information about HITACHI RAIL USA INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HITACHI RAIL USA INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 QUINCY QUINTANA 2021-03-02
501 2019-01-01 QUINCY QUINTANA 2020-07-28

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-01-01	QUINCY QUINTANA	2021-03-02
501	2019-01-01	QUINCY QUINTANA	2020-07-28

Plan Statistics for HITACHI RAIL USA INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for HITACHI RAIL USA INC. WELFARE BENEFIT PLAN

Measure Date Value
2020: HITACHI RAIL USA INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 86
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 86
Number of employers contributing to the scheme 2020-01-01 0
2019: HITACHI RAIL USA INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 100
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 100
Number of employers contributing to the scheme 2019-01-01 1

Measure	Date	Value
2020: HITACHI RAIL USA INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	86
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	86
Number of employers contributing to the scheme	2020-01-01	0
2019: HITACHI RAIL USA INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	100
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	100
Number of employers contributing to the scheme	2019-01-01	1

Form 5500 Responses for HITACHI RAIL USA INC. WELFARE BENEFIT PLAN

2020: HITACHI RAIL USA INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: HITACHI RAIL USA INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	First time form 5500 has been submitted	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

533909

Policy instance

Insurance contract or identification number	533909
Number of Individuals Covered	86
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $10,444
Total amount of fees paid to insurance company	USD $6,282
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
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 $153,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,444
Amount paid for insurance broker fees	6282
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )

Policy contract number

D0033

Policy instance

Insurance contract or identification number	D0033
Number of Individuals Covered	86
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $72,817
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $72,817
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

533909

Policy instance

Insurance contract or identification number	533909
Number of Individuals Covered	100
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $9,545
Total amount of fees paid to insurance company	USD $5,202
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
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 $158,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,545
Amount paid for insurance broker fees	5202
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

Potentially related plans

HITACHI RAIL HONOLULU JV RETIREMENT/SAVINGS PLAN [EIN = 273131075]

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Company Name:	HITACHI RAIL USA INC
Employer identification number (EIN):	133093379
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	0927115