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ESSENTIAL PRODUCTS INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameESSENTIAL PRODUCTS INC. WELFARE BENEFIT PLAN
Plan identification number 501

ESSENTIAL PRODUCTS INC. WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • 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

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

Company Name:ESSENTIAL PRODUCTS, INC.
Employer identification number (EIN):364821801
NAIC Classification:334200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ESSENTIAL PRODUCTS INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-03-01ERIKA B. ORTIZ2019-08-09

Plan Statistics for ESSENTIAL PRODUCTS INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for ESSENTIAL PRODUCTS INC. WELFARE BENEFIT PLAN

Measure Date Value
2018: ESSENTIAL PRODUCTS INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-03-01126
Total number of active participants reported on line 7a of the Form 55002018-03-0190
Number of retired or separated participants receiving benefits2018-03-015
Number of other retired or separated participants entitled to future benefits2018-03-013
Total of all active and inactive participants2018-03-0198
Number of employers contributing to the scheme2018-03-010

Form 5500 Responses for ESSENTIAL PRODUCTS INC. WELFARE BENEFIT PLAN

2018: ESSENTIAL PRODUCTS INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01First time form 5500 has been submittedYes
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number622027
Policy instance 1
Insurance contract or identification number622027
Number of Individuals Covered98
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $47,674
Total amount of fees paid to insurance companyUSD $19,070
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $952,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,674
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT FEES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30081772
Policy instance 2
Insurance contract or identification number30081772
Number of Individuals Covered70
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $990
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $990
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05950665
Policy instance 4
Insurance contract or identification numberTS05950665
Number of Individuals Covered338
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $20,997
Total amount of fees paid to insurance companyUSD $103
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $152,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,998
Amount paid for insurance broker fees103
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number716924
Policy instance 3
Insurance contract or identification number716924
Number of Individuals Covered54
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $15,121
Total amount of fees paid to insurance companyUSD $752
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $305,379
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 fees752
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number530113
Policy instance 5
Insurance contract or identification number530113
Number of Individuals Covered85
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $9,551
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $75,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,269
Amount paid for insurance broker fees0
Insurance broker organization code?3

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