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ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN
Plan identification number 501

ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 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
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

ACHEN-GARDNER CONSTRUCTION, LLC has sponsored the creation of one or more 401k plans.

Company Name:ACHEN-GARDNER CONSTRUCTION, LLC
Employer identification number (EIN):271394157
NAIC Classification:237310
NAIC Description:Highway, Street, and Bridge Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-09-01
5012017-09-01
5012016-09-01
5012015-09-01JOHN WALSTROM
5012012-09-01JOHN WALSTROM
5012011-09-01LIDIA GUTIERREZ

Plan Statistics for ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN

401k plan membership statisitcs for ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN

Measure Date Value
2018: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01151
Total number of active participants reported on line 7a of the Form 55002018-09-010
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-010
2017: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01105
Total number of active participants reported on line 7a of the Form 55002017-09-01151
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01151
2016: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-0183
Total number of active participants reported on line 7a of the Form 55002016-09-01105
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01105
2015: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01152
Total number of active participants reported on line 7a of the Form 55002015-09-0183
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-0183
2012: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01110
Total number of active participants reported on line 7a of the Form 55002012-09-0185
Number of retired or separated participants receiving benefits2012-09-010
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-0185
2011: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01164
Total number of active participants reported on line 7a of the Form 55002011-09-01146
Number of retired or separated participants receiving benefits2011-09-010
Number of other retired or separated participants entitled to future benefits2011-09-010
Total of all active and inactive participants2011-09-01146

Form 5500 Responses for ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN

2018: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01This submission is the final filingYes
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan funding arrangement – General assets of the sponsorYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – General assets of the sponsorYes
2017: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan funding arrangement – General assets of the sponsorYes
2017-09-01Plan benefit arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – General assets of the sponsorYes
2016: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan funding arrangement – General assets of the sponsorYes
2016-09-01Plan benefit arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – General assets of the sponsorYes
2015: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan funding arrangement – General assets of the sponsorYes
2015-09-01Plan benefit arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – General assets of the sponsorYes
2012: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedYes
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – General assets of the sponsorYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – General assets of the sponsorYes
2011: ACHEN-GARDNER CONSTRUCTION, LLC HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan funding arrangement – General assets of the sponsorYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EMPLOYERS DENTAL SERVICES (National Association of Insurance Commissioners NAIC id number: 53090 )
Policy contract number17867/17883
Policy instance 1
Insurance contract or identification number17867/17883
Number of Individuals Covered71
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $698
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $387
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1029263
Policy instance 2
Insurance contract or identification number1029263
Number of Individuals Covered260
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $15,076
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $162,358
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,360
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00014144
Policy instance 3
Insurance contract or identification numberER00014144
Number of Individuals Covered191
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $46,033
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $253,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,793
Insurance broker organization code?3
AVESIS INSURANCE INCORPORATED (National Association of Insurance Commissioners NAIC id number: 11163 )
Policy contract number11007-1013
Policy instance 4
Insurance contract or identification number11007-1013
Number of Individuals Covered174
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $1,629
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,017
Insurance broker organization code?3
EMPLOYERS DENTAL SERVICES (National Association of Insurance Commissioners NAIC id number: 53090 )
Policy contract number17867/17883
Policy instance 1
Insurance contract or identification number17867/17883
Number of Individuals Covered78
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $618
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,854
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 number1029263
Policy instance 2
Insurance contract or identification number1029263
Number of Individuals Covered271
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $12,164
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $154,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00014144
Policy instance 3
Insurance contract or identification numberER00014144
Number of Individuals Covered170
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $48,202
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $268,470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AVESIS INSURANCE INCORPORATED (National Association of Insurance Commissioners NAIC id number: 11163 )
Policy contract number11007-1013
Policy instance 4
Insurance contract or identification number11007-1013
Number of Individuals Covered179
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $1,665
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,589
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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