401k Plan data: PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN plan

PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN
Plan identification number	503

PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental 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.

401k Sponsoring company profile

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

Company Name: PADGETT, INC.

Employer identification number (EIN): 351107908

NAIC Classification: 332900

Additional information about PADGETT, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 1996-02-14

Company Identification Number: 932924

Legal Registered Office Address: 119 E COURT ST STE 407
-
CINCINNATI
United States of America (USA)
452021203

More information about PADGETT, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2015-01-01

Plan Statistics for PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN

401k plan membership statisitcs for PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2015: PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 93
Total of all active and inactive participants 2015-01-01 93
Total participants 2015-01-01 93

Measure	Date	Value
2015: PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	93
Total of all active and inactive participants	2015-01-01	93
Total participants	2015-01-01	93

Form 5500 Responses for PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN

2015: PADGETT, INC. HEALTH & WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

634458

Policy instance

Insurance contract or identification number	634458
Number of Individuals Covered	66
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $16,162
Total amount of fees paid to insurance company	USD $317
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	WELLNESS PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $186,604
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,162
Amount paid for insurance broker fees	317
Additional information about fees paid to insurance broker	BONUSES
Insurance broker organization code?	3
Insurance broker name	ASSURED NL INS AGENCY, INC.

DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )

Policy contract number

03952801

Policy instance

Insurance contract or identification number	03952801
Number of Individuals Covered	127
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G 00613013

Policy instance

Insurance contract or identification number	G 00613013
Number of Individuals Covered	93
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $8,997
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $69,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,997
Insurance broker organization code?	3
Insurance broker name	ASSURED NL INS AGENCY, INC.

CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )

Policy contract number

19792

Policy instance

Insurance contract or identification number	19792
Number of Individuals Covered	69
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,297
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITA
Welfare Benefit Premiums Paid to Carrier	USD $21,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7
Insurance broker organization code?	3
Insurance broker name	SHAWN M COLIN

COLONIAL LIFE (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

E8949828

Policy instance

Insurance contract or identification number	E8949828
Number of Individuals Covered	5
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Other welfare benefits provided	ACCIDENT, UNIV LIFE, SICKNESS
Welfare Benefit Premiums Paid to Carrier	USD $2,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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Company Name:	PADGETT, INC.
Employer identification number (EIN):	351107908
NAIC Classification:	332900

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	1996-02-14
Company Identification Number:	932924
Legal Registered Office Address:	119 E COURT ST STE 407 - CINCINNATI United States of America (USA) 452021203