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| Plan Name | ESM GROUP INC. SELF FUNDED MEDICAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | OPTA USA, INC |
| Employer identification number (EIN): | 251589289 |
| NAIC Classification: | 331110 |
| NAIC Description: | Iron and Steel Mills and Ferroalloy Manufacturing |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-09-01 | ||||
| 501 | 2018-01-01 | HEATHER SCHRATZ | HEATHER SCHRATZ | 2019-07-18 | |
| 501 | 2017-01-01 | HEATHER SCHRATZ | HEATHER SCHRATZ | 2018-10-04 | |
| 501 | 2016-01-01 | HEATHER SCHRATZ | HEATHER SCHRATZ | 2017-07-28 | |
| 501 | 2015-01-01 | HEATHER SCHRATZ | HEATHER SCHRATZ | 2016-07-12 | |
| 501 | 2014-01-01 | HEATHER SCHRATZ | HEATHER SCHRATZ | 2015-10-07 | |
| 501 | 2013-01-01 | CRISTINA HIGGINS | CRISTINA HIGGINS | 2014-07-30 | |
| 501 | 2012-01-01 | CRISTINA HIGGINS | CRISTINA HIGGINS | 2013-10-02 | |
| 501 | 2011-01-01 | CRISTINA HIGGINS | CRISTINA HIGGINS | 2012-10-12 | |
| 501 | 2010-01-01 | CRISTINA HIGGINS | CRISTINA HIGGINS | 2011-10-17 | |
| 501 | 2009-01-01 | CRISTINA HIGGINS | CRISTINA HIGGINS | 2010-10-07 |
| 2020: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-09-01 | Type of plan entity | Single employer plan |
| 2020-09-01 | First time form 5500 has been submitted | Yes |
| 2020-09-01 | Plan funding arrangement – Insurance | Yes |
| 2020-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2017 form 5500 responses | ||
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2016 form 5500 responses | ||
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2014 form 5500 responses | ||
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2013 form 5500 responses | ||
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2010 form 5500 responses | ||
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: ESM GROUP INC. SELF FUNDED MEDICAL PLAN 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00576886 |
| Policy instance | 2 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 0149899 |
| Policy instance | 1 |
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: 55204 ) | |
| Policy contract number | 00413285 |
| Policy instance | 2 |
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |
| Policy contract number | 00093962 |
| Policy instance | 1 |
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: 55204 ) | |
| Policy contract number | 00413285 |
| Policy instance | 2 |
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |
| Policy contract number | 00093962 |
| Policy instance | 1 |
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: 55204 ) | |
| Policy contract number | 00413285 |
| Policy instance | 3 |
| COFINITY (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | H92 |
| Policy instance | 2 |
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |
| Policy contract number | 00093962 |
| Policy instance | 1 |
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: 55204 ) | |
| Policy contract number | 00413285 |
| Policy instance | 3 |
| COFINITY (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | H92 |
| Policy instance | 2 |
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |
| Policy contract number | 00093962 |
| Policy instance | 1 |
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: 55204 ) | |
| Policy contract number | 00413362 |
| Policy instance | 4 |
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |
| Policy contract number | 00093962 |
| Policy instance | 1 |
| COFINITY (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | H92 |
| Policy instance | 2 |
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: 55204 ) | |
| Policy contract number | 00413285 |
| Policy instance | 3 |
| HM LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60213 ) | |
| Policy contract number | 404057 |
| Policy instance | 2 |
| COFINITY (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | H92 |
| Policy instance | 3 |
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |
| Policy contract number | 00093962 |
| Policy instance | 1 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) | |
| Policy contract number | 9960-7961 |
| Policy instance | 2 |
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |
| Policy contract number | 00093962 |
| Policy instance | 1 |
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 9960-7961 |
| Policy instance | 3 |
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 ) | |
| Policy contract number | 31886F |
| Policy instance | 2 |
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 95308 ) | |
| Policy contract number | 31886H |
| Policy instance | 1 |
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