401k Plan data: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) plan

KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 401k Plan overview

Plan Name	KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL)
Plan identification number	503

KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 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)

401k Sponsoring company profile

KENDRION (SHELBY) INC. has sponsored the creation of one or more 401k plans.

Company Name: KENDRION (SHELBY) INC.

Employer identification number (EIN): 208284552

NAIC Classification: 336300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL)

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2023-04-01
503 2023-04-01 KIM RICHARDSON
503 2022-04-01
503 2022-04-01 KIM RICHARDSON
503 2021-04-01
503 2021-04-01 KIM RICHARDSON
503 2020-04-01
503 2019-04-01
503 2017-04-01 PAULA VINCENT PAULA VINCENT 2018-08-13
503 2016-04-01 PAULA VINCENT PAULA VINCENT 2017-10-31
503 2015-04-01 PAULA VINCENT PAULA VINCENT 2016-10-03
503 2014-04-01 STEPHANIE OLIVER STEPHANIE OLIVER 2015-09-25
503 2013-01-01 STEPHANIE OLIVER STEPHANIE OLIVER 2014-07-25
503 2012-01-01 STEPHANIE OLIVER STEPHANIE OLIVER 2013-07-30
503 2011-01-01 STEPHANIE OLIVER STEPHANIE OLIVER 2012-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2023-04-01
503	2023-04-01	KIM RICHARDSON
503	2022-04-01
503	2022-04-01	KIM RICHARDSON
503	2021-04-01
503	2021-04-01	KIM RICHARDSON
503	2020-04-01
503	2019-04-01
503	2017-04-01	PAULA VINCENT	PAULA VINCENT	2018-08-13
503	2016-04-01	PAULA VINCENT	PAULA VINCENT	2017-10-31
503	2015-04-01	PAULA VINCENT	PAULA VINCENT	2016-10-03
503	2014-04-01	STEPHANIE OLIVER	STEPHANIE OLIVER	2015-09-25
503	2013-01-01	STEPHANIE OLIVER	STEPHANIE OLIVER	2014-07-25
503	2012-01-01	STEPHANIE OLIVER	STEPHANIE OLIVER	2013-07-30
503	2011-01-01	STEPHANIE OLIVER	STEPHANIE OLIVER	2012-10-15

Plan Statistics for KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL)

401k plan membership statisitcs for KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL)

Measure Date Value
2023: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2023 401k membership
Total participants, beginning-of-year 2023-04-01 224
Total number of active participants reported on line 7a of the Form 5500 2023-04-01 192
Total of all active and inactive participants 2023-04-01 192
2022: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2022 401k membership
Total participants, beginning-of-year 2022-04-01 251
Total number of active participants reported on line 7a of the Form 5500 2022-04-01 224
Total of all active and inactive participants 2022-04-01 224
2021: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2021 401k membership
Total participants, beginning-of-year 2021-04-01 272
Total number of active participants reported on line 7a of the Form 5500 2021-04-01 251
Total of all active and inactive participants 2021-04-01 251
2020: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2020 401k membership
Total participants, beginning-of-year 2020-04-01 292
Total number of active participants reported on line 7a of the Form 5500 2020-04-01 272
Total of all active and inactive participants 2020-04-01 272
2019: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2019 401k membership
Total participants, beginning-of-year 2019-04-01 302
Total number of active participants reported on line 7a of the Form 5500 2019-04-01 292
Total of all active and inactive participants 2019-04-01 292
2017: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2017 401k membership
Total participants, beginning-of-year 2017-04-01 342
Total number of active participants reported on line 7a of the Form 5500 2017-04-01 344
Total of all active and inactive participants 2017-04-01 344
2016: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2016 401k membership
Total participants, beginning-of-year 2016-04-01 210
Total number of active participants reported on line 7a of the Form 5500 2016-04-01 342
Total of all active and inactive participants 2016-04-01 342
2015: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2015 401k membership
Total participants, beginning-of-year 2015-04-01 236
Total number of active participants reported on line 7a of the Form 5500 2015-04-01 230
Total of all active and inactive participants 2015-04-01 230
2014: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2014 401k membership
Total participants, beginning-of-year 2014-04-01 234
Total number of active participants reported on line 7a of the Form 5500 2014-04-01 236
Total of all active and inactive participants 2014-04-01 236
2013: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2013 401k membership
Total participants, beginning-of-year 2013-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 234
Total of all active and inactive participants 2013-01-01 234
2012: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2012 401k membership
Total participants, beginning-of-year 2012-01-01 211
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 218
Total of all active and inactive participants 2012-01-01 218
2011: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2011 401k membership
Total participants, beginning-of-year 2011-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 211
Total of all active and inactive participants 2011-01-01 211

Measure	Date	Value
2023: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2023 401k membership
Total participants, beginning-of-year	2023-04-01	224
Total number of active participants reported on line 7a of the Form 5500	2023-04-01	192
Total of all active and inactive participants	2023-04-01	192
2022: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2022 401k membership
Total participants, beginning-of-year	2022-04-01	251
Total number of active participants reported on line 7a of the Form 5500	2022-04-01	224
Total of all active and inactive participants	2022-04-01	224
2021: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2021 401k membership
Total participants, beginning-of-year	2021-04-01	272
Total number of active participants reported on line 7a of the Form 5500	2021-04-01	251
Total of all active and inactive participants	2021-04-01	251
2020: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2020 401k membership
Total participants, beginning-of-year	2020-04-01	292
Total number of active participants reported on line 7a of the Form 5500	2020-04-01	272
Total of all active and inactive participants	2020-04-01	272
2019: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2019 401k membership
Total participants, beginning-of-year	2019-04-01	302
Total number of active participants reported on line 7a of the Form 5500	2019-04-01	292
Total of all active and inactive participants	2019-04-01	292
2017: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2017 401k membership
Total participants, beginning-of-year	2017-04-01	342
Total number of active participants reported on line 7a of the Form 5500	2017-04-01	344
Total of all active and inactive participants	2017-04-01	344
2016: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2016 401k membership
Total participants, beginning-of-year	2016-04-01	210
Total number of active participants reported on line 7a of the Form 5500	2016-04-01	342
Total of all active and inactive participants	2016-04-01	342
2015: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2015 401k membership
Total participants, beginning-of-year	2015-04-01	236
Total number of active participants reported on line 7a of the Form 5500	2015-04-01	230
Total of all active and inactive participants	2015-04-01	230
2014: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2014 401k membership
Total participants, beginning-of-year	2014-04-01	234
Total number of active participants reported on line 7a of the Form 5500	2014-04-01	236
Total of all active and inactive participants	2014-04-01	236
2013: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2013 401k membership
Total participants, beginning-of-year	2013-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	234
Total of all active and inactive participants	2013-01-01	234
2012: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2012 401k membership
Total participants, beginning-of-year	2012-01-01	211
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	218
Total of all active and inactive participants	2012-01-01	218
2011: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2011 401k membership
Total participants, beginning-of-year	2011-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	211
Total of all active and inactive participants	2011-01-01	211

Form 5500 Responses for KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL)

2023: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2023 form 5500 responses
2023-04-01	Type of plan entity	Single employer plan
2023-04-01	Plan funding arrangement – Insurance	Yes
2023-04-01	Plan benefit arrangement – Insurance	Yes
2022: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2022 form 5500 responses
2022-04-01	Type of plan entity	Single employer plan
2022-04-01	Plan funding arrangement – Insurance	Yes
2022-04-01	Plan benefit arrangement – Insurance	Yes
2021: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2021 form 5500 responses
2021-04-01	Type of plan entity	Single employer plan
2021-04-01	Plan funding arrangement – Insurance	Yes
2021-04-01	Plan benefit arrangement – Insurance	Yes
2020: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2020 form 5500 responses
2020-04-01	Type of plan entity	Single employer plan
2020-04-01	Plan funding arrangement – Insurance	Yes
2020-04-01	Plan benefit arrangement – Insurance	Yes
2019: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2019 form 5500 responses
2019-04-01	Type of plan entity	Single employer plan
2019-04-01	Plan funding arrangement – Insurance	Yes
2019-04-01	Plan benefit arrangement – Insurance	Yes
2017: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2017 form 5500 responses
2017-04-01	Type of plan entity	Single employer plan
2017-04-01	Plan funding arrangement – Insurance	Yes
2017-04-01	Plan benefit arrangement – Insurance	Yes
2016: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	Plan funding arrangement – Insurance	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes
2015: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2015 form 5500 responses
2015-04-01	Type of plan entity	Single employer plan
2015-04-01	Plan funding arrangement – Insurance	Yes
2015-04-01	Plan benefit arrangement – Insurance	Yes
2014: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2014 form 5500 responses
2014-04-01	Type of plan entity	Single employer plan
2014-04-01	Plan funding arrangement – Insurance	Yes
2014-04-01	Plan benefit arrangement – Insurance	Yes
2013: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: KENDRION (SHELBY), INC. (LIFE, AD&D, DISABILITY & DENTAL) 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161359-1001

Policy instance

Insurance contract or identification number	14161359-1001
Number of Individuals Covered	192
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $23,975
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,458,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161359-1001

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161359-1001

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161359-1001

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

911074

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

911074

Policy instance

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

Policy contract number

00466349

Policy instance

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

Policy contract number

000NF312

Policy instance

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

Policy contract number

000NF312

Policy instance

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

06463

Policy instance

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

Policy contract number

NF312

Policy instance

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

06463

Policy instance

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

06463

Policy instance

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Company Name:	KENDRION (SHELBY) INC.
Employer identification number (EIN):	208284552
NAIC Classification:	336300