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MOBIS WELFARE BENEFIT PLAN 401k Plan overview

Plan NameMOBIS WELFARE BENEFIT PLAN
Plan identification number 504

MOBIS WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

MOBIS PARTS AMERICA LLC has sponsored the creation of one or more 401k plans.

Company Name:MOBIS PARTS AMERICA LLC
Employer identification number (EIN):200262739
NAIC Classification:441300
NAIC Description: Automotive Parts, Accessories, and Tire Stores

Additional information about MOBIS PARTS AMERICA LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3709264

More information about MOBIS PARTS AMERICA LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MOBIS WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042020-08-01
5042019-08-01
5042018-08-01
5042017-08-01MARY CALDERON
5042016-08-01JENNIFER SIDHOM
5042015-08-01SHERRY THOMAS
5042014-08-01SHERRY THOMAS
5042013-08-01SHERRY THOMAS
5042012-08-01SHERRY THOMAS
5042011-08-01SHERRY THOMAS
5042010-08-01SHERRY THOMAS
5042009-08-01SHERRY THOMAS

Plan Statistics for MOBIS WELFARE BENEFIT PLAN

401k plan membership statisitcs for MOBIS WELFARE BENEFIT PLAN

Measure Date Value
2020: MOBIS WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01663
Total number of active participants reported on line 7a of the Form 55002020-08-01648
Number of retired or separated participants receiving benefits2020-08-013
Total of all active and inactive participants2020-08-01651
Total participants2020-08-01651
2019: MOBIS WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01645
Total number of active participants reported on line 7a of the Form 55002019-08-01663
Number of retired or separated participants receiving benefits2019-08-014
Total of all active and inactive participants2019-08-01667
Total participants2019-08-01667
2018: MOBIS WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01578
Total number of active participants reported on line 7a of the Form 55002018-08-01645
Total of all active and inactive participants2018-08-01645
Total participants2018-08-01645
2017: MOBIS WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01566
Total number of active participants reported on line 7a of the Form 55002017-08-01578
Number of retired or separated participants receiving benefits2017-08-0112
Total of all active and inactive participants2017-08-01590
Total participants2017-08-01590
2016: MOBIS WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01498
Total number of active participants reported on line 7a of the Form 55002016-08-01559
Number of retired or separated participants receiving benefits2016-08-017
Total of all active and inactive participants2016-08-01566
Total participants2016-08-01566
2015: MOBIS WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01474
Total number of active participants reported on line 7a of the Form 55002015-08-01498
Total of all active and inactive participants2015-08-01498
Total participants2015-08-010
2014: MOBIS WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01452
Total number of active participants reported on line 7a of the Form 55002014-08-01474
Total of all active and inactive participants2014-08-01474
Total participants2014-08-010
2013: MOBIS WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01412
Total number of active participants reported on line 7a of the Form 55002013-08-01452
Total of all active and inactive participants2013-08-01452
Total participants2013-08-010
2012: MOBIS WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01886
Total number of active participants reported on line 7a of the Form 55002012-08-01412
Total of all active and inactive participants2012-08-01412
Total participants2012-08-010
2011: MOBIS WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01302
Total number of active participants reported on line 7a of the Form 55002011-08-01886
Total of all active and inactive participants2011-08-01886
Total participants2011-08-01886
2010: MOBIS WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-08-01301
Total number of active participants reported on line 7a of the Form 55002010-08-01302
Total of all active and inactive participants2010-08-01302
Total participants2010-08-01302
2009: MOBIS WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01211
Total number of active participants reported on line 7a of the Form 55002009-08-01822
Total of all active and inactive participants2009-08-01822
Total participants2009-08-01822

Form 5500 Responses for MOBIS WELFARE BENEFIT PLAN

2020: MOBIS WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – InsuranceYes
2019: MOBIS WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – InsuranceYes
2018: MOBIS WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – InsuranceYes
2017: MOBIS WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: MOBIS WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes
2015: MOBIS WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – InsuranceYes
2014: MOBIS WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes
2013: MOBIS WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: MOBIS WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – InsuranceYes
2011: MOBIS WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – InsuranceYes
2010: MOBIS WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – InsuranceYes
2009: MOBIS WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01First time form 5500 has been submittedYes
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0149873-504
Policy instance 3
Insurance contract or identification number0149873-504
Number of Individuals Covered1503
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $211,216
Total amount of fees paid to insurance companyUSD $64,219
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,786,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $211,216
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION AND TRAINING
Insurance broker organization code?3
Amount paid for insurance broker fees64219
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract numberGA9086
Policy instance 2
Insurance contract or identification numberGA9086
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $1,476
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,476
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA9086
Policy instance 1
Insurance contract or identification numberGA9086
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $10,590
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,590
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract numberGA9086
Policy instance 2
Insurance contract or identification numberGA9086
Number of Individuals Covered1539
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $18,669
Total amount of fees paid to insurance companyUSD $4,023
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $927,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,669
Amount paid for insurance broker fees4023
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION AND TRAINING
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA9086
Policy instance 1
Insurance contract or identification numberGA9086
Number of Individuals Covered1551
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $134,386
Total amount of fees paid to insurance companyUSD $28,955
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,675,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $134,386
Amount paid for insurance broker fees28955
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION AND TRAINING
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract numberGA9086
Policy instance 2
Insurance contract or identification numberGA9086
Number of Individuals Covered645
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $44
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA9086
Policy instance 1
Insurance contract or identification numberGA9086
Number of Individuals Covered1474
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $103,490
Total amount of fees paid to insurance companyUSD $66
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,791,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $103,490
Insurance broker organization code?3
Amount paid for insurance broker fees66
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION AND TRAINING
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract numberGA9086
Policy instance 2
Insurance contract or identification numberGA9086
Number of Individuals Covered1346
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $11,750
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $625,813
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA9086
Policy instance 1
Insurance contract or identification numberGA9086
Number of Individuals Covered1369
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $113,390
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,039,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0835187
Policy instance 2
Insurance contract or identification number0835187
Number of Individuals Covered1267
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $66,370
Total amount of fees paid to insurance companyUSD $59,196
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,281,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $66,370
Amount paid for insurance broker fees59196
Additional information about fees paid to insurance brokerENGAGEMENT CREDIT/ PM CROSS SALE
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER & CO
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0835187HNO
Policy instance 1
Insurance contract or identification number0835187HNO
Number of Individuals Covered569
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $39,487
Welfare Benefit Premiums Paid to CarrierUSD $2,000,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,487
Insurance broker nameJ SMITH LANIER & CO
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0835187HNO
Policy instance 2
Insurance contract or identification number0835187HNO
Number of Individuals Covered543
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $34,455
Welfare Benefit Premiums Paid to CarrierUSD $1,872,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,455
Insurance broker nameJ SMITH LANIER & CO
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0835187
Policy instance 1
Insurance contract or identification number0835187
Number of Individuals Covered1195
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $52,522
Total amount of fees paid to insurance companyUSD $3,176
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,806,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,522
Amount paid for insurance broker fees3176
Additional information about fees paid to insurance brokerPM CROSS SALE
Insurance broker organization code?0
Insurance broker nameJ SMITH LANIER & CO
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number234546
Policy instance 1
Insurance contract or identification number234546
Number of Individuals Covered452
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $29,568
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $591,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,568
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER & CO
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number234546
Policy instance 1
Insurance contract or identification number234546
Number of Individuals Covered412
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $23,938
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $478,761
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,938
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER & CO
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number717158
Policy instance 1
Insurance contract or identification number717158
Number of Individuals Covered886
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $14,785
Total amount of fees paid to insurance companyUSD $5,000
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $295,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0717158
Policy instance 1
Insurance contract or identification number0717158
Number of Individuals Covered302
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $14,253
Total amount of fees paid to insurance companyUSD $5,000
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $278,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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