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CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 401k Plan overview

Plan NameCLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN
Plan identification number 502

CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance

401k Sponsoring company profile

CLARENCE DAVIDS AND COMPANY has sponsored the creation of one or more 401k plans.

Company Name:CLARENCE DAVIDS AND COMPANY
Employer identification number (EIN):362856807
NAIC Classification:561730
NAIC Description:Landscaping Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-01-01JESSICA ROBERTS2022-05-31
5022021-01-01WILLIAM DAVIDS2023-09-13
5022019-11-01JESSICA ROBERTS2021-05-27
5022018-11-01JESSICA ROBERTS2020-05-27
5022017-11-01JESSICA ROBERTS2019-05-15
5022016-11-01
5022015-11-01
5022014-11-01
5022013-11-01
5022012-11-01SHERYL BORGMAN
5022011-11-01SHERYL BORGMAN
5022010-11-01SHERYL BORGMAN
5022009-11-01SHERYL BORGMAN

Plan Statistics for CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN

401k plan membership statisitcs for CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN

Measure Date Value
2021: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01110
Total number of active participants reported on line 7a of the Form 55002021-01-01103
Total of all active and inactive participants2021-01-01103
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
2019: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-01105
Total number of active participants reported on line 7a of the Form 55002019-11-01110
Total of all active and inactive participants2019-11-01110
2018: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-11-0182
Total number of active participants reported on line 7a of the Form 55002018-11-01105
Number of retired or separated participants receiving benefits2018-11-010
Number of other retired or separated participants entitled to future benefits2018-11-010
Total of all active and inactive participants2018-11-01105
2017: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-11-01115
Total number of active participants reported on line 7a of the Form 55002017-11-0182
Number of retired or separated participants receiving benefits2017-11-010
Number of other retired or separated participants entitled to future benefits2017-11-010
Total of all active and inactive participants2017-11-0182
2016: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-01117
Total number of active participants reported on line 7a of the Form 55002016-11-01115
Total of all active and inactive participants2016-11-01115
2015: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-11-01106
Total number of active participants reported on line 7a of the Form 55002015-11-01117
Total of all active and inactive participants2015-11-01117
2014: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-01108
Total number of active participants reported on line 7a of the Form 55002014-11-01106
Number of retired or separated participants receiving benefits2014-11-010
Number of other retired or separated participants entitled to future benefits2014-11-010
Total of all active and inactive participants2014-11-01106
2013: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-0199
Total number of active participants reported on line 7a of the Form 55002013-11-01108
Number of retired or separated participants receiving benefits2013-11-010
Number of other retired or separated participants entitled to future benefits2013-11-010
Total of all active and inactive participants2013-11-01108
2012: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-0197
Total number of active participants reported on line 7a of the Form 55002012-11-0199
Number of retired or separated participants receiving benefits2012-11-010
Number of other retired or separated participants entitled to future benefits2012-11-010
Total of all active and inactive participants2012-11-0199
2011: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-01101
Total number of active participants reported on line 7a of the Form 55002011-11-0197
Number of retired or separated participants receiving benefits2011-11-010
Number of other retired or separated participants entitled to future benefits2011-11-010
Total of all active and inactive participants2011-11-0197
2010: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-11-01116
Total number of active participants reported on line 7a of the Form 55002010-11-01101
Number of retired or separated participants receiving benefits2010-11-010
Number of other retired or separated participants entitled to future benefits2010-11-010
Total of all active and inactive participants2010-11-01101
2009: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-11-01126
Total number of active participants reported on line 7a of the Form 55002009-11-01116
Number of retired or separated participants receiving benefits2009-11-010
Number of other retired or separated participants entitled to future benefits2009-11-010
Total of all active and inactive participants2009-11-01116

Form 5500 Responses for CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN

2021: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2019: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – InsuranceYes
2018: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – InsuranceYes
2017: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – InsuranceYes
2016: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – InsuranceYes
2015: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – InsuranceYes
2014: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – InsuranceYes
2013: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan benefit arrangement – InsuranceYes
2012: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – InsuranceYes
2011: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan benefit arrangement – InsuranceYes
2010: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2010 form 5500 responses
2010-11-01Type of plan entitySingle employer plan
2010-11-01Plan funding arrangement – InsuranceYes
2010-11-01Plan benefit arrangement – InsuranceYes
2009: CLARENCE DAVIDS & COMPANY LIFE INSURANCE PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01This submission is the final filingNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022357
Policy instance 1
Insurance contract or identification numberF022357
Number of Individuals Covered103
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,885
Total amount of fees paid to insurance companyUSD $681
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $12,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,885
Amount paid for insurance broker fees681
Insurance broker organization code?3
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Additional information about fees paid to insurance brokerFEES
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022357
Policy instance 1
Insurance contract or identification numberF022357
Number of Individuals Covered110
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $1,848
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $12,339
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,848
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022357
Policy instance 1
Insurance contract or identification numberF022357
Number of Individuals Covered105
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $1,943
Total amount of fees paid to insurance companyUSD $759
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $13,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,943
Amount paid for insurance broker fees759
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number302732
Policy instance 1
Insurance contract or identification number302732
Number of Individuals Covered0
Insurance policy start date2017-11-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $263
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF022357
Policy instance 2
Insurance contract or identification numberF022357
Number of Individuals Covered82
Insurance policy start date2018-02-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $990
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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