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COLLAGEN MATRIX, INC.- MEDICAL PLAN 401k Plan overview

Plan NameCOLLAGEN MATRIX, INC.- MEDICAL PLAN
Plan identification number 502

COLLAGEN MATRIX, INC.- MEDICAL PLAN Benefits

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

401k Sponsoring company profile

COLLAGEN MATRIX, INC. has sponsored the creation of one or more 401k plans.

Company Name:COLLAGEN MATRIX, INC.
Employer identification number (EIN):223513886
NAIC Classification:621510
NAIC Description: Medical and Diagnostic Laboratories

Additional information about COLLAGEN MATRIX, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2751605

More information about COLLAGEN MATRIX, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLLAGEN MATRIX, INC.- MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-06-01OYSTEIN VALBERG2023-07-27
5022021-06-01OYSTEIN VALBERG2022-11-29
5022020-06-01PAIGE RAFFEL2021-11-15
5022019-06-01PAIGE RAFFEL2020-10-07
5022018-06-01
5022017-06-01
5022016-06-01
5022015-06-01

Plan Statistics for COLLAGEN MATRIX, INC.- MEDICAL PLAN

401k plan membership statisitcs for COLLAGEN MATRIX, INC.- MEDICAL PLAN

Measure Date Value
2022: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01112
Total number of active participants reported on line 7a of the Form 55002022-06-01115
Number of retired or separated participants receiving benefits2022-06-013
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-01118
2021: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01106
Total number of active participants reported on line 7a of the Form 55002021-06-01112
Number of retired or separated participants receiving benefits2021-06-010
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01112
2020: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01118
Total number of active participants reported on line 7a of the Form 55002020-06-01102
Number of retired or separated participants receiving benefits2020-06-011
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01103
2019: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-0182
Total number of active participants reported on line 7a of the Form 55002019-06-01118
Number of retired or separated participants receiving benefits2019-06-013
Total of all active and inactive participants2019-06-01121
2018: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01112
Total number of active participants reported on line 7a of the Form 55002018-06-01117
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01117
2017: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01106
Total number of active participants reported on line 7a of the Form 55002017-06-01110
Number of retired or separated participants receiving benefits2017-06-012
Total of all active and inactive participants2017-06-01112
2016: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01119
Total number of active participants reported on line 7a of the Form 55002016-06-01110
Total of all active and inactive participants2016-06-01110
2015: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01126
Total number of active participants reported on line 7a of the Form 55002015-06-01116
Total of all active and inactive participants2015-06-01116

Form 5500 Responses for COLLAGEN MATRIX, INC.- MEDICAL PLAN

2022: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – InsuranceYes
2021: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes
2020: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes
2019: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: COLLAGEN MATRIX, INC.- MEDICAL PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: COLLAGEN MATRIX, INC.- MEDICAL 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

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00613644
Policy instance 1
Insurance contract or identification number00613644
Number of Individuals Covered157
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $45,760
Total amount of fees paid to insurance companyUSD $13,872
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $806,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,760
Insurance broker organization code?3
Amount paid for insurance broker fees13872
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00613644
Policy instance 1
Insurance contract or identification number00613644
Number of Individuals Covered140
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $621,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00613644
Policy instance 1
Insurance contract or identification number00613644
Number of Individuals Covered126
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $46,897
Total amount of fees paid to insurance companyUSD $14,241
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $585,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,897
Amount paid for insurance broker fees18
Additional information about fees paid to insurance brokerINVENTIVE COMPENSATION
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00613644
Policy instance 1
Insurance contract or identification number00613644
Number of Individuals Covered146
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $41,479
Total amount of fees paid to insurance companyUSD $14,308
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $529,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,479
Insurance broker organization code?3
Amount paid for insurance broker fees14308
Additional information about fees paid to insurance brokerGENERAL AGENT FEE
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00613644
Policy instance 1
Insurance contract or identification number00613644
Number of Individuals Covered150
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $31,383
Total amount of fees paid to insurance companyUSD $12,553
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $406,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,383
Insurance broker organization code?3
Amount paid for insurance broker fees12553
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00613644
Policy instance 1
Insurance contract or identification number00613644
Number of Individuals Covered132
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $36,225
Total amount of fees paid to insurance companyUSD $14,490
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $366,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,225
Insurance broker organization code?3
Amount paid for insurance broker fees14490
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT PAYMENTS
Insurance broker nameEMERSON REID & COMPANY, INC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00613644
Policy instance 1
Insurance contract or identification number00613644
Number of Individuals Covered129
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $19,900
Total amount of fees paid to insurance companyUSD $7,960
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $133,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,900
Insurance broker organization code?3
Amount paid for insurance broker fees7960
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker nameEMERSON REID & COMPANY, INC

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