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CLEAN VENTURE EMPLOYEE WELFARE PLAN 401k Plan overview

Plan NameCLEAN VENTURE EMPLOYEE WELFARE PLAN
Plan identification number 501

CLEAN VENTURE EMPLOYEE WELFARE PLAN Benefits

401k Plan TypeWelfare 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

401k Sponsoring company profile

CLEAN VENTURE, INC. has sponsored the creation of one or more 401k plans.

Company Name:CLEAN VENTURE, INC.
Employer identification number (EIN):222149233
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLEAN VENTURE EMPLOYEE WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-06-01
5012017-06-01
5012016-06-01AIDA GARCIA
5012016-06-01
5012015-06-01AIDA GARCIA
5012014-06-01MICHAEL PERSICO
5012013-06-01MICHAEL PERSICO

Plan Statistics for CLEAN VENTURE EMPLOYEE WELFARE PLAN

401k plan membership statisitcs for CLEAN VENTURE EMPLOYEE WELFARE PLAN

Measure Date Value
2017: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01506
Total number of active participants reported on line 7a of the Form 55002017-06-010
Number of retired or separated participants receiving benefits2017-06-010
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-010
2016: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01561
Total number of active participants reported on line 7a of the Form 55002016-06-01506
Number of retired or separated participants receiving benefits2016-06-010
Number of other retired or separated participants entitled to future benefits2016-06-010
Total of all active and inactive participants2016-06-01506
2015: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01540
Total number of active participants reported on line 7a of the Form 55002015-06-01561
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-01561
2014: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01538
Total number of active participants reported on line 7a of the Form 55002014-06-01540
Total of all active and inactive participants2014-06-01540
Total participants2014-06-01540
2013: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01398
Total number of active participants reported on line 7a of the Form 55002013-06-01538
Total of all active and inactive participants2013-06-01538
Total participants2013-06-01538

Form 5500 Responses for CLEAN VENTURE EMPLOYEE WELFARE PLAN

2017: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Submission has been amendedYes
2017-06-01This submission is the final filingYes
2017-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Submission has been amendedYes
2016-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Submission has been amendedNo
2014-06-01This submission is the final filingNo
2014-06-01This return/report is a short plan year return/report (less than 12 months)No
2014-06-01Plan is a collectively bargained planNo
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: CLEAN VENTURE EMPLOYEE WELFARE PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01First time form 5500 has been submittedYes
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00304119
Policy instance 1
Insurance contract or identification number00304119
Number of Individuals Covered133
Insurance policy start date2017-06-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,698
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,698
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0149666
Policy instance 2
Insurance contract or identification number0149666
Number of Individuals Covered456
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $8,339
Total amount of fees paid to insurance companyUSD $1,278
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $92,171
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,339
Amount paid for insurance broker fees57
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC

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