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COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 401k Plan overview

Plan NameCOLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL
Plan identification number 505

COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Death benefits (include travel accident but not life insurance)
  • 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.- BUSINESS TRAVEL ACCIDENT PL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052021-01-01OYSTEIN VALBERG2022-10-17
5052020-01-01PAIGE RAFFEL2021-10-15
5052019-01-01PAIGE RAFFEL2020-10-07
5052018-01-01
5052017-01-01
5052016-01-01

Plan Statistics for COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL

401k plan membership statisitcs for COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL

Measure Date Value
2021: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2021 401k membership
Total participants, beginning-of-year2021-01-01159
Total number of active participants reported on line 7a of the Form 55002021-01-01159
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01159
2020: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2020 401k membership
Total participants, beginning-of-year2020-01-01180
Total number of active participants reported on line 7a of the Form 55002020-01-01159
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01159
2019: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2019 401k membership
Total participants, beginning-of-year2019-01-01189
Total number of active participants reported on line 7a of the Form 55002019-01-01201
Total of all active and inactive participants2019-01-01201
2018: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2018 401k membership
Total participants, beginning-of-year2018-01-01162
Total number of active participants reported on line 7a of the Form 55002018-01-01171
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01171
2017: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2017 401k membership
Total participants, beginning-of-year2017-01-01168
Total number of active participants reported on line 7a of the Form 55002017-01-01170
Total of all active and inactive participants2017-01-01170
2016: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2016 401k membership
Total participants, beginning-of-year2016-01-01142
Total number of active participants reported on line 7a of the Form 55002016-01-01158
Total of all active and inactive participants2016-01-01158

Form 5500 Responses for COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL

2021: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: COLLAGEN MATRIX, INC.- BUSINESS TRAVEL ACCIDENT PL 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099075340
Policy instance 1
Insurance contract or identification number000099075340
Number of Individuals Covered159
Insurance policy start date2019-04-08
Insurance policy end date2020-04-08
Total amount of commissions paid to insurance brokerUSD $495
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $495
Insurance broker organization code?3
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099075340
Policy instance 1
Insurance contract or identification number000099075340
Number of Individuals Covered192
Insurance policy start date2018-04-08
Insurance policy end date2019-04-08
Total amount of commissions paid to insurance brokerUSD $495
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $495
Insurance broker organization code?3
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099075340
Policy instance 1
Insurance contract or identification number000099075340
Number of Individuals Covered175
Insurance policy start date2017-04-08
Insurance policy end date2018-04-08
Total amount of commissions paid to insurance brokerUSD $439
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $439
Insurance broker organization code?3
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099075340
Policy instance 1
Insurance contract or identification number000099075340
Number of Individuals Covered170
Insurance policy start date2016-04-08
Insurance policy end date2017-04-08
Total amount of commissions paid to insurance brokerUSD $439
Total amount of fees paid to insurance companyUSD $22
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $439
Amount paid for insurance broker fees22
Additional information about fees paid to insurance brokerGUARANTEED SUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameOTTERSTEDT INS AGENCY INC

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