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UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501) 401k Plan overview

Plan NameUNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501)
Plan identification number 501

UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501) 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
  • Other welfare benefit cover

401k Sponsoring company profile

UNIQUESOURCE PRODUCTS & SERVICES has sponsored the creation of one or more 401k plans.

Company Name:UNIQUESOURCE PRODUCTS & SERVICES
Employer identification number (EIN):231523064
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501)

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01JACQUELINE N WILLIAMS
5012023-01-01
5012023-01-01JACQUELINE N WILLIAMS
5012022-12-01
5012022-12-01JACQUELINE N WILLIAMS
5012021-12-01
5012021-12-01
5012021-12-01JACQUELINE N WILLIAMS

Financial Data on UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501)

Measure Date Value
2023 : UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501) 2023 401k financial data
Total plan liabilities at end of year2023-12-31$71,082
Total plan liabilities at beginning of year2023-12-31$127,367
Total income from all sources2023-12-31$849,449
Expenses. Total of all expenses incurred2023-12-31$870,612
Benefits paid (including direct rollovers)2023-12-31$551,378
Total plan assets at end of year2023-12-31$2,972
Total plan assets at beginning of year2023-12-31$80,420
Value of fidelity bond covering the plan2023-12-31$500,000
Total contributions received or receivable from participants2023-12-31$0
Expenses. Other expenses not covered elsewhere2023-12-31$316,240
Contributions received from other sources (not participants or employers)2023-12-31$23,475
Other income received2023-12-31$1,397
Net income (gross income less expenses)2023-12-31$-21,163
Net plan assets at end of year (total assets less liabilities)2023-12-31$-68,110
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$-46,947
Total contributions received or receivable from employer(s)2023-12-31$824,577
Value of corrective distributions2023-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$2,994
2022 : UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501) 2022 401k financial data
Total plan liabilities at end of year2022-12-31$127,367
Total plan liabilities at beginning of year2022-12-31$154,554
Total income from all sources2022-12-31$64,633
Expenses. Total of all expenses incurred2022-12-31$25,720
Benefits paid (including direct rollovers)2022-12-31$-503
Total plan assets at end of year2022-12-31$80,420
Total plan assets at beginning of year2022-12-31$68,694
Value of fidelity bond covering the plan2022-12-31$500,000
Expenses. Other expenses not covered elsewhere2022-12-31$25,935
Other income received2022-12-31$14
Net income (gross income less expenses)2022-12-31$38,913
Net plan assets at end of year (total assets less liabilities)2022-12-31$-46,947
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$-85,860
Total contributions received or receivable from employer(s)2022-12-31$64,619
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$288
Total plan liabilities at end of year2022-11-30$154,554
Total plan liabilities at beginning of year2022-11-30$0
Total income from all sources2022-11-30$706,170
Expenses. Total of all expenses incurred2022-11-30$792,030
Benefits paid (including direct rollovers)2022-11-30$506,395
Total plan assets at end of year2022-11-30$68,694
Total plan assets at beginning of year2022-11-30$0
Value of fidelity bond covering the plan2022-11-30$500,000
Expenses. Other expenses not covered elsewhere2022-11-30$282,559
Other income received2022-11-30$146
Net income (gross income less expenses)2022-11-30$-85,860
Net plan assets at end of year (total assets less liabilities)2022-11-30$-85,860
Net plan assets at beginning of year (total assets less liabilities)2022-11-30$0
Total contributions received or receivable from employer(s)2022-11-30$706,024
Expenses. Administrative service providers (salaries,fees and commissions)2022-11-30$3,076

Form 5500 Responses for UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501)

2023: UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501) 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501) 2022 form 5500 responses
2022-12-01Type of plan entitySingle employer plan
2022-12-01Submission has been amendedNo
2022-12-01This submission is the final filingNo
2022-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-12-01Plan is a collectively bargained planNo
2022-12-01Plan funding arrangement – InsuranceYes
2022-12-01Plan funding arrangement – TrustYes
2022-12-01Plan funding arrangement – General assets of the sponsorYes
2022-12-01Plan benefit arrangement – InsuranceYes
2022-12-01Plan benefit arrangement - TrustYes
2022-12-01Plan benefit arrangement – General assets of the sponsorYes
2021: UNIQUESOURCE PRODUCTS & SERVICES GROUP HEALTH PLAN (501) 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01First time form 5500 has been submittedYes
2021-12-01Submission has been amendedNo
2021-12-01This submission is the final filingNo
2021-12-01This return/report is a short plan year return/report (less than 12 months)No
2021-12-01Plan is a collectively bargained planNo
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – TrustYes
2021-12-01Plan funding arrangement – General assets of the sponsorYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement - TrustYes
2021-12-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL30500809
Policy instance 5
Insurance contract or identification numberSL30500809
Number of Individuals Covered0
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $-644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1041482
Policy instance 4
Insurance contract or identification number1041482
Number of Individuals Covered74
Insurance policy start date2023-01-01
Insurance policy end date2023-12-30
Total amount of commissions paid to insurance brokerUSD $6,837
Total amount of fees paid to insurance companyUSD $544
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $56,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number62290
Policy instance 3
Insurance contract or identification number62290
Number of Individuals Covered100
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $364
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $5,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number450001-226
Policy instance 2
Insurance contract or identification number450001-226
Number of Individuals Covered97
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $3,583
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $35,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract numberUNI-203562
Policy instance 1
Insurance contract or identification numberUNI-203562
Number of Individuals Covered40
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $287,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1041482
Policy instance 4
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number62290
Policy instance 3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number450001-226
Policy instance 2
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number30500809
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1041482
Policy instance 4
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number62290
Policy instance 3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number450001-226
Policy instance 2
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number30500809
Policy instance 1

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