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COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN 401k Plan overview

Plan NameCOLLAGEN MATRIX, INC.- DENTAL & VISION PLAN
Plan identification number 504

COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • Vision
  • Other welfare benefit cover

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.- DENTAL & VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-06-01OYSTEIN VALBERG2023-11-07
5042021-06-01OYSTEIN VALBERG2022-11-29
5042020-06-01PAIGE RAFFEL2021-11-15
5042019-06-01PAIGE RAFFEL2020-10-07
5042018-06-01
5042017-06-01
5042016-06-01
5042015-06-01

Plan Statistics for COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN

401k plan membership statisitcs for COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN

Measure Date Value
2022: COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01113
Total number of active participants reported on line 7a of the Form 55002022-06-01122
Number of retired or separated participants receiving benefits2022-06-010
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-01122
2021: COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01114
Total number of active participants reported on line 7a of the Form 55002021-06-01112
Number of retired or separated participants receiving benefits2021-06-011
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01113
2020: COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01124
Total number of active participants reported on line 7a of the Form 55002020-06-01108
Number of retired or separated participants receiving benefits2020-06-012
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01110
2019: COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-0187
Total number of active participants reported on line 7a of the Form 55002019-06-01124
Total of all active and inactive participants2019-06-01124
2018: COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01111
Total number of active participants reported on line 7a of the Form 55002018-06-01119
Number of retired or separated participants receiving benefits2018-06-011
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01120
2017: COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01114
Total number of active participants reported on line 7a of the Form 55002017-06-01111
Total of all active and inactive participants2017-06-01111
2016: COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01121
Total number of active participants reported on line 7a of the Form 55002016-06-01114
Total of all active and inactive participants2016-06-01114
2015: COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01102
Total number of active participants reported on line 7a of the Form 55002015-06-01126
Total of all active and inactive participants2015-06-01126

Form 5500 Responses for COLLAGEN MATRIX, INC.- DENTAL & VISION PLAN

2022: COLLAGEN MATRIX, INC.- DENTAL & VISION 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.- DENTAL & VISION 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.- DENTAL & VISION 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.- DENTAL & VISION 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.- DENTAL & VISION 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.- DENTAL & VISION 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.- DENTAL & VISION 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.- DENTAL & VISION 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 number0613644
Policy instance 1
Insurance contract or identification number0613644
Number of Individuals Covered123
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $11,024
Total amount of fees paid to insurance companyUSD $6,358
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $148,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,024
Insurance broker organization code?3
Amount paid for insurance broker fees6358
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0613644
Policy instance 1
Insurance contract or identification number0613644
Number of Individuals Covered114
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,904
Total amount of fees paid to insurance companyUSD $4,076
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $119,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,904
Insurance broker organization code?3
Amount paid for insurance broker fees2422
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0613644
Policy instance 1
Insurance contract or identification number0613644
Number of Individuals Covered107
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $8,742
Total amount of fees paid to insurance companyUSD $3,981
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $117,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,742
Amount paid for insurance broker fees18
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0613644
Policy instance 1
Insurance contract or identification number0613644
Number of Individuals Covered124
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $8,727
Total amount of fees paid to insurance companyUSD $3,926
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $116,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,727
Insurance broker organization code?3
Amount paid for insurance broker fees3926
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0613644
Policy instance 1
Insurance contract or identification number0613644
Number of Individuals Covered129
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,294
Total amount of fees paid to insurance companyUSD $3,847
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $113,924
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,294
Insurance broker organization code?3
Amount paid for insurance broker fees3847
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0613644
Policy instance 1
Insurance contract or identification number0613644
Number of Individuals Covered114
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,745
Total amount of fees paid to insurance companyUSD $3,506
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,745
Insurance broker organization code?3
Amount paid for insurance broker fees3506
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT PAYMENTS
Insurance broker nameEMERSON REID & COMPANY, INC

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