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MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 401k Plan overview

Plan NameMITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN
Plan identification number 502

MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN Benefits

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

401k Sponsoring company profile

MITAS TIRES NORTH AMERICA, INC. has sponsored the creation of one or more 401k plans.

Company Name:MITAS TIRES NORTH AMERICA, INC.
Employer identification number (EIN):134103544
NAIC Classification:441300
NAIC Description: Automotive Parts, Accessories, and Tire Stores

Additional information about MITAS TIRES NORTH AMERICA, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3185723

More information about MITAS TIRES NORTH AMERICA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-04-01
5022016-04-01
5022015-04-01DIANNE POOLE
5022014-04-01DIANNE POOLE
5022013-04-01DIANNE POOLE

Plan Statistics for MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN

401k plan membership statisitcs for MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN

Measure Date Value
2017: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01157
Total number of active participants reported on line 7a of the Form 55002017-04-01159
Number of retired or separated participants receiving benefits2017-04-010
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01159
2016: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01140
Total number of active participants reported on line 7a of the Form 55002016-04-01157
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01157
2015: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01160
Total number of active participants reported on line 7a of the Form 55002015-04-01140
Number of retired or separated participants receiving benefits2015-04-010
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01140
2014: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01158
Total number of active participants reported on line 7a of the Form 55002014-04-01160
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-01160
2013: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01100
Total number of active participants reported on line 7a of the Form 55002013-04-01158
Number of retired or separated participants receiving benefits2013-04-010
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-01158

Form 5500 Responses for MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN

2017: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD 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 filingNo
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: MITAS TIRES OF NORTH AMERICA MEDICAL, LIFE AND STD PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number904953
Policy instance 1
Insurance contract or identification number904953
Number of Individuals Covered209
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $63,398
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,205,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees63398
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10203526
Policy instance 2
Insurance contract or identification number10203526
Number of Individuals Covered159
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $3,313
Total amount of fees paid to insurance companyUSD $480
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $39,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,313
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.

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