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GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 401k Plan overview

Plan NameGRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN
Plan identification number 501

GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

GRAND RIVER RUBBER & PLASTICS COMPANY has sponsored the creation of one or more 401k plans.

Company Name:GRAND RIVER RUBBER & PLASTICS COMPANY
Employer identification number (EIN):310887443
NAIC Classification:326200

Additional information about GRAND RIVER RUBBER & PLASTICS COMPANY

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1976-07-28
Company Identification Number: 484849
Legal Registered Office Address: 134 WEST 46TH STREET
-
ASHTABULA
United States of America (USA)
44004

More information about GRAND RIVER RUBBER & PLASTICS COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01DONALD CHAPLIN DONALD CHAPLIN2018-07-11
5012016-01-01DONALD CHAPLIN DONALD CHAPLIN2017-07-28
5012015-01-01DONALD CHAPLIN DONALD CHAPLIN2016-10-17
5012014-01-01DONALD CHAPLIN DONALD CHAPLIN2015-11-17
5012013-01-01RICHARD SELIP RICHARD SELIP2014-10-10
5012012-01-01RICHARD SELIP RICHARD SELIP2013-10-10
5012011-01-01RICHARD SELIP RICHARD SELIP2012-10-05
5012009-01-01RICHARD SELIP RICHARD SELIP2010-09-21

Plan Statistics for GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN

401k plan membership statisitcs for GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN

Measure Date Value
2017: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01211
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
2016: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01211
Total number of active participants reported on line 7a of the Form 55002016-01-01211
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01211
2015: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01203
Total number of active participants reported on line 7a of the Form 55002015-01-01211
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01211
2014: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01191
Total number of active participants reported on line 7a of the Form 55002014-01-01203
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01203
2013: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01194
Total number of active participants reported on line 7a of the Form 55002013-01-01191
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01191
2012: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01195
Total number of active participants reported on line 7a of the Form 55002012-01-01194
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01194
2011: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01184
Total number of active participants reported on line 7a of the Form 55002011-01-01195
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01195
2009: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01178
Total number of active participants reported on line 7a of the Form 55002009-01-01182
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01182
Total participants2009-01-010

Form 5500 Responses for GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN

2017: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: GRAND RIVER RUBBER & PLASTICS COMPANY HEALTH & WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number0009K842
Policy instance 2
Insurance contract or identification number0009K842
Number of Individuals Covered214
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $9,225
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $276,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees9225
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES LLC
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00173276
Policy instance 1
Insurance contract or identification number00173276
Number of Individuals Covered178
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $900
Welfare Benefit Premiums Paid to CarrierUSD $516,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees900
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATION, AND TRAINING
Insurance broker organization code?3
Insurance broker nameUSI MIDWEST LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number228198
Policy instance 3
Insurance contract or identification number228198
Number of Individuals Covered211
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,956
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00173276
Policy instance 2
Insurance contract or identification number00173276
Number of Individuals Covered158
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $336,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberK2289/K2842
Policy instance 1
Insurance contract or identification numberK2289/K2842
Number of Individuals Covered205
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $11,914
Total amount of fees paid to insurance companyUSD $5,901
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $182,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,914
Amount paid for insurance broker fees5901
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Insurance broker nameEXPRESSLINK GENERAL AGENCY LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0253328
Policy instance 2
Insurance contract or identification numberR0253328
Number of Individuals Covered0
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $192
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $192
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameHEALTHCORP SOLUTIONS
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number228198
Policy instance 3
Insurance contract or identification number228198
Number of Individuals Covered197
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberK2289/K2842
Policy instance 1
Insurance contract or identification numberK2289/K2842
Number of Individuals Covered203
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $9,882
Total amount of fees paid to insurance companyUSD $7,249
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $138,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,882
Amount paid for insurance broker fees7249
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Insurance broker nameEXPRESSLINK GENERAL AGENCY LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0253328
Policy instance 2
Insurance contract or identification numberR0253328
Number of Individuals Covered181
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $3,199
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,199
Insurance broker organization code?3
Insurance broker nameHEALTHCORP SOLUTIONS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberK2289/K2842
Policy instance 1
Insurance contract or identification numberK2289/K2842
Number of Individuals Covered191
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $9,395
Total amount of fees paid to insurance companyUSD $7,023
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $127,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,395
Amount paid for insurance broker fees7023
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Insurance broker nameEXPRESSLINK GENERAL AGENCY LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00456992
Policy instance 2
Insurance contract or identification number00456992
Number of Individuals Covered194
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $8,325
Total amount of fees paid to insurance companyUSD $6,979
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $128,491
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,289
Amount paid for insurance broker fees6979
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Insurance broker nameALPHA BENEFITS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0253328
Policy instance 1
Insurance contract or identification numberR0253328
Number of Individuals Covered191
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $3,285
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedSTD TRAD 09
Welfare Benefit Premiums Paid to CarrierUSD $46,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,285
Insurance broker organization code?3
Insurance broker nameHEALTHCORP SOLUTIONS
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract numberR0253328
Policy instance 1
Insurance contract or identification numberR0253328
Number of Individuals Covered194
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $3,454
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedSTD TRAD 09
Welfare Benefit Premiums Paid to CarrierUSD $42,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00456992
Policy instance 2
Insurance contract or identification number00456992
Number of Individuals Covered195
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $6,533
Total amount of fees paid to insurance companyUSD $5,649
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $122,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5232777
Policy instance 1
Insurance contract or identification number5232777
Number of Individuals Covered184
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $6,396
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $54,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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