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LIFE/AD&D 401k Plan overview

Plan NameLIFE/AD&D
Plan identification number 501

LIFE/AD&D Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

PREVENTIVE DIAGNOSTICS, INC has sponsored the creation of one or more 401k plans.

Company Name:PREVENTIVE DIAGNOSTICS, INC
Employer identification number (EIN):272335313
NAIC Classification:621510
NAIC Description: Medical and Diagnostic Laboratories

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE/AD&D

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-04-01MENACHEM TAUBER2024-10-10
5012022-04-01MENACHEM TAUBER2024-01-08

Plan Statistics for LIFE/AD&D

401k plan membership statisitcs for LIFE/AD&D

Measure Date Value
2023: LIFE/AD&D 2023 401k membership
Total participants, beginning-of-year2023-04-01116
Total number of active participants reported on line 7a of the Form 55002023-04-01160
Number of retired or separated participants receiving benefits2023-04-010
Number of other retired or separated participants entitled to future benefits2023-04-010
Total of all active and inactive participants2023-04-01160
Number of employers contributing to the scheme2023-04-010
2022: LIFE/AD&D 2022 401k membership
Total participants, beginning-of-year2022-04-01117
Total number of active participants reported on line 7a of the Form 55002022-04-01116
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01116
Number of employers contributing to the scheme2022-04-010

Form 5500 Responses for LIFE/AD&D

2023: LIFE/AD&D 2023 form 5500 responses
2023-04-01Type of plan entitySingle employer plan
2023-04-01Plan funding arrangement – InsuranceYes
2023-04-01Plan benefit arrangement – InsuranceYes
2022: LIFE/AD&D 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01First time form 5500 has been submittedYes
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMP 0C4CT
Policy instance 1
Insurance contract or identification numberMP 0C4CT
Number of Individuals Covered160
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $64
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 )
Policy contract numberGLCL0C4CT
Policy instance 2
Insurance contract or identification numberGLCL0C4CT
Number of Individuals Covered160
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 )
Policy contract numberGCEL0C4CT
Policy instance 3
Insurance contract or identification numberGCEL0C4CT
Number of Individuals Covered31
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGMAD0C4CT
Policy instance 4
Insurance contract or identification numberGMAD0C4CT
Number of Individuals Covered31
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0C4CT
Policy instance 1
Insurance contract or identification numberGLUG0C4CT
Number of Individuals Covered131
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $377
Total amount of fees paid to insurance companyUSD $167
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $377
Amount paid for insurance broker fees53
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3

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