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ROBERT MCCABE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameROBERT MCCABE WELFARE BENEFIT PLAN
Plan identification number 501

ROBERT MCCABE WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • 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.

401k Sponsoring company profile

ROBERT MCCABE COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROBERT MCCABE COMPANY, INC.
Employer identification number (EIN):311126383
NAIC Classification:444130
NAIC Description:Hardware Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROBERT MCCABE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-07-01JEFF TEPE2022-10-28
5012021-07-01JEFF TEPE2023-08-25
5012020-07-01JEFF TEPE2021-11-11
5012019-07-01JEFF TEPE2020-11-24
5012018-07-01JEFF TEPE2019-10-26
5012017-07-01
5012016-07-01
5012015-07-01

Plan Statistics for ROBERT MCCABE WELFARE BENEFIT PLAN

401k plan membership statisitcs for ROBERT MCCABE WELFARE BENEFIT PLAN

Measure Date Value
2021: ROBERT MCCABE WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01101
Total number of active participants reported on line 7a of the Form 55002021-07-0191
Number of retired or separated participants receiving benefits2021-07-011
Total of all active and inactive participants2021-07-0192
2020: ROBERT MCCABE WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01101
Total number of active participants reported on line 7a of the Form 55002020-07-0193
Total of all active and inactive participants2020-07-0193
2019: ROBERT MCCABE WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01132
Total number of active participants reported on line 7a of the Form 55002019-07-01194
Number of retired or separated participants receiving benefits2019-07-011
Total of all active and inactive participants2019-07-01195
2018: ROBERT MCCABE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01143
Total number of active participants reported on line 7a of the Form 55002018-07-01132
Total of all active and inactive participants2018-07-01132
2017: ROBERT MCCABE WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01137
Total number of active participants reported on line 7a of the Form 55002017-07-01143
Total of all active and inactive participants2017-07-01143
Total participants2017-07-01143
2016: ROBERT MCCABE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01114
Total number of active participants reported on line 7a of the Form 55002016-07-01137
Total of all active and inactive participants2016-07-01137
Total participants2016-07-01137
2015: ROBERT MCCABE WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01124
Total number of active participants reported on line 7a of the Form 55002015-07-01114
Total of all active and inactive participants2015-07-01114
Total participants2015-07-01114

Form 5500 Responses for ROBERT MCCABE WELFARE BENEFIT PLAN

2021: ROBERT MCCABE WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedYes
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: ROBERT MCCABE WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: ROBERT MCCABE WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: ROBERT MCCABE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: ROBERT MCCABE WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: ROBERT MCCABE WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: ROBERT MCCABE WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01First time form 5500 has been submittedYes
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1129573
Policy instance 1
Insurance contract or identification number1129573
Number of Individuals Covered161
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $10,022
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,022
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1129573
Policy instance 1
Insurance contract or identification number1129573
Number of Individuals Covered165
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $9,636
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,636
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number7F0163
Policy instance 1
Insurance contract or identification number7F0163
Number of Individuals Covered194
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $28,063
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LIFE/AD&D
Welfare Benefit Premiums Paid to CarrierUSD $684,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,063
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberOH2023
Policy instance 2
Insurance contract or identification numberOH2023
Number of Individuals Covered132
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,188
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 numberOH2023
Policy instance 1
Insurance contract or identification numberOH2023
Number of Individuals Covered160
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $34,443
Total amount of fees paid to insurance companyUSD $1,739
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $695,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,443
Amount paid for insurance broker fees1739
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number769556
Policy instance 4
Insurance contract or identification number769556
Number of Individuals Covered143
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $920
Total amount of fees paid to insurance companyUSD $200
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,330
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $920
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLANG FINANCIAL GROUP, INC.
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number769556
Policy instance 3
Insurance contract or identification number769556
Number of Individuals Covered83
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $899
Total amount of fees paid to insurance companyUSD $286
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $899
Amount paid for insurance broker fees286
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLANG FINANCIAL GROUP, INC.
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number769556
Policy instance 2
Insurance contract or identification number769556
Number of Individuals Covered95
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $2,734
Total amount of fees paid to insurance companyUSD $1,554
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,734
Amount paid for insurance broker fees1554
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLANG FINANCIAL GROUP, INC.
HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 )
Policy contract number769556
Policy instance 1
Insurance contract or identification number769556
Number of Individuals Covered88
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $18,350
Total amount of fees paid to insurance companyUSD $4,679
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $617,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,350
Amount paid for insurance broker fees4679
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLANG FINANCIAL GROUP, INC.
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00173538
Policy instance 4
Insurance contract or identification number00173538
Number of Individuals Covered114
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $580
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $580
Insurance broker organization code?3
Insurance broker nameLANG FINANCIAL GROUP, INC.
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9846395
Policy instance 3
Insurance contract or identification number9846395
Number of Individuals Covered130
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,452
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 number218483
Policy instance 2
Insurance contract or identification number218483
Number of Individuals Covered80
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $1,904
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,904
Insurance broker organization code?3
Insurance broker nameLANG FINANCIAL GROUP, INC.
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00173538
Policy instance 1
Insurance contract or identification number00173538
Number of Individuals Covered123
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $25,603
Total amount of fees paid to insurance companyUSD $800
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $481,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,603
Amount paid for insurance broker fees800
Insurance broker organization code?3
Insurance broker nameLANG FINANCIAL GROUP, INC.

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