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ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 401k Plan overview

Plan NameULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN
Plan identification number 503

ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

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

Company Name:ULTIMATE HYDROFORMING, INC.
Employer identification number (EIN):382242395
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-03-01SHIRLEY KLYN
5032022-03-01SHIRLEY KLYN
5032021-03-01SHIRLEY KLYN
5032020-03-01SHIRLEY KLYN2021-10-20
5032019-03-01SHIRLEY KLYN2020-12-04
5032018-03-01SHIRLEY KLYN2019-12-05
5032017-03-01
5032016-03-01
5032015-03-01

Financial Data on ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN

Measure Date Value
2024 : ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2024 401k financial data
Total income from all sources (including contributions)2024-02-29$2,405,876
Total of all expenses incurred2024-02-29$2,405,876
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2024-02-29$2,405,876
Total contributions o plan (from employers,participants, others, non cash contrinutions)2024-02-29$2,405,876
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2024-02-29No
Was this plan covered by a fidelity bond2024-02-29No
If this is an individual account plan, was there a blackout period2024-02-29No
Were there any nonexempt tranactions with any party-in-interest2024-02-29No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2024-02-29No
Value of net income/loss2024-02-29$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2024-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2024-02-29No
Were any leases to which the plan was party in default or uncollectible2024-02-29No
Expenses. Payments to insurance carriers foe the provision of benefits2024-02-29$2,405,876
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2024-02-29No
Was there a failure to transmit to the plan any participant contributions2024-02-29No
Has the plan failed to provide any benefit when due under the plan2024-02-29No
Contributions received in cash from employer2024-02-29$2,405,876
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32024-02-29No
Did the plan have assets held for investment2024-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2024-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2024-02-29No
2023 : ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2023 401k financial data
Total income from all sources (including contributions)2023-03-01$2,405,876
Total of all expenses incurred2023-03-01$2,405,876
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-03-01$2,405,876
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-03-01$2,405,876
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-03-01No
Was this plan covered by a fidelity bond2023-03-01No
If this is an individual account plan, was there a blackout period2023-03-01No
Were there any nonexempt tranactions with any party-in-interest2023-03-01No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-03-01No
Value of net income/loss2023-03-01$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-03-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-03-01No
Were any leases to which the plan was party in default or uncollectible2023-03-01No
Expenses. Payments to insurance carriers foe the provision of benefits2023-03-01$2,405,876
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-03-01No
Was there a failure to transmit to the plan any participant contributions2023-03-01No
Has the plan failed to provide any benefit when due under the plan2023-03-01No
Contributions received in cash from employer2023-03-01$2,405,876
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-03-01No
Did the plan have assets held for investment2023-03-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-03-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-03-01No
Total income from all sources (including contributions)2023-02-28$2,117,375
Total of all expenses incurred2023-02-28$2,117,375
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-02-28$2,117,375
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-02-28$2,117,375
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-02-28No
Was this plan covered by a fidelity bond2023-02-28No
If this is an individual account plan, was there a blackout period2023-02-28No
Were there any nonexempt tranactions with any party-in-interest2023-02-28No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-28No
Value of net income/loss2023-02-28$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2023-02-28No
Were any leases to which the plan was party in default or uncollectible2023-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2023-02-28$2,117,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-02-28No
Was there a failure to transmit to the plan any participant contributions2023-02-28No
Has the plan failed to provide any benefit when due under the plan2023-02-28No
Contributions received in cash from employer2023-02-28$2,117,375
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-02-28No
Did the plan have assets held for investment2023-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-02-28No
2022 : ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2022 401k financial data
Total income from all sources (including contributions)2022-03-01$2,117,375
Total of all expenses incurred2022-03-01$2,117,375
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-03-01$2,117,375
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-03-01$2,117,375
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-03-01No
Was this plan covered by a fidelity bond2022-03-01No
If this is an individual account plan, was there a blackout period2022-03-01No
Were there any nonexempt tranactions with any party-in-interest2022-03-01No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-01No
Value of net income/loss2022-03-01$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-03-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-03-01No
Were any leases to which the plan was party in default or uncollectible2022-03-01No
Expenses. Payments to insurance carriers foe the provision of benefits2022-03-01$2,117,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-03-01No
Was there a failure to transmit to the plan any participant contributions2022-03-01No
Has the plan failed to provide any benefit when due under the plan2022-03-01No
Contributions received in cash from employer2022-03-01$2,117,375
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-03-01No
Did the plan have assets held for investment2022-03-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-03-01No
Total income from all sources (including contributions)2022-02-28$1,624,460
Total of all expenses incurred2022-02-28$1,624,460
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-02-28$1,624,460
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-02-28$1,624,460
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-02-28No
Was this plan covered by a fidelity bond2022-02-28No
If this is an individual account plan, was there a blackout period2022-02-28No
Were there any nonexempt tranactions with any party-in-interest2022-02-28No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-02-28No
Value of net income/loss2022-02-28$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2022-02-28No
Were any leases to which the plan was party in default or uncollectible2022-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2022-02-28$1,624,460
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-02-28No
Was there a failure to transmit to the plan any participant contributions2022-02-28No
Has the plan failed to provide any benefit when due under the plan2022-02-28No
Contributions received in cash from employer2022-02-28$1,624,460
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-02-28No
Did the plan have assets held for investment2022-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-02-28No
2021 : ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-02-28$1,910,375
Total of all expenses incurred2021-02-28$1,910,375
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-02-28$1,910,375
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-02-28$1,910,375
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-02-28No
Was this plan covered by a fidelity bond2021-02-28No
If this is an individual account plan, was there a blackout period2021-02-28No
Were there any nonexempt tranactions with any party-in-interest2021-02-28No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-28No
Value of net income/loss2021-02-28$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2021-02-28No
Were any leases to which the plan was party in default or uncollectible2021-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2021-02-28$1,910,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-02-28No
Was there a failure to transmit to the plan any participant contributions2021-02-28No
Has the plan failed to provide any benefit when due under the plan2021-02-28No
Contributions received in cash from employer2021-02-28$1,910,375
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-02-28No
Did the plan have assets held for investment2021-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-02-28No
2020 : ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-02-29$1,973,748
Total of all expenses incurred2020-02-29$1,973,748
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-02-29$1,973,748
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-02-29$1,973,748
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-02-29No
Was this plan covered by a fidelity bond2020-02-29No
If this is an individual account plan, was there a blackout period2020-02-29No
Were there any nonexempt tranactions with any party-in-interest2020-02-29No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-02-29No
Value of net income/loss2020-02-29$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2020-02-29No
Were any leases to which the plan was party in default or uncollectible2020-02-29No
Expenses. Payments to insurance carriers foe the provision of benefits2020-02-29$1,973,748
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-02-29No
Was there a failure to transmit to the plan any participant contributions2020-02-29No
Has the plan failed to provide any benefit when due under the plan2020-02-29No
Contributions received in cash from employer2020-02-29$1,973,748
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-02-29No
Did the plan have assets held for investment2020-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-02-29No
2019 : ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2019 401k financial data
Total income from all sources (including contributions)2019-02-28$1,664,716
Total of all expenses incurred2019-02-28$1,664,716
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-02-28$1,664,716
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-02-28$1,664,716
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-02-28No
Was this plan covered by a fidelity bond2019-02-28No
If this is an individual account plan, was there a blackout period2019-02-28No
Were there any nonexempt tranactions with any party-in-interest2019-02-28No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-02-28No
Value of net income/loss2019-02-28$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2019-02-28No
Were any leases to which the plan was party in default or uncollectible2019-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2019-02-28$1,664,716
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-02-28No
Was there a failure to transmit to the plan any participant contributions2019-02-28No
Has the plan failed to provide any benefit when due under the plan2019-02-28No
Contributions received in cash from employer2019-02-28$1,664,716
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-02-28No
Did the plan have assets held for investment2019-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-02-28No
2018 : ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-02-28$1,791,811
Total of all expenses incurred2018-02-28$1,791,811
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-02-28$1,791,811
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-02-28$1,791,811
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-02-28No
Was this plan covered by a fidelity bond2018-02-28No
If this is an individual account plan, was there a blackout period2018-02-28No
Were there any nonexempt tranactions with any party-in-interest2018-02-28No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Value of net income/loss2018-02-28$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2018-02-28No
Were any leases to which the plan was party in default or uncollectible2018-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2018-02-28$1,791,811
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-02-28No
Was there a failure to transmit to the plan any participant contributions2018-02-28No
Has the plan failed to provide any benefit when due under the plan2018-02-28No
Contributions received in cash from employer2018-02-28$1,791,811
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-02-28No
Did the plan have assets held for investment2018-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-02-28No
2017 : ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-02-28$1,635,838
Total of all expenses incurred2017-02-28$1,635,838
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-02-28$1,635,838
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-02-28$1,635,838
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-02-28No
Was this plan covered by a fidelity bond2017-02-28No
If this is an individual account plan, was there a blackout period2017-02-28No
Were there any nonexempt tranactions with any party-in-interest2017-02-28No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Value of net income/loss2017-02-28$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2017-02-28No
Were any leases to which the plan was party in default or uncollectible2017-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2017-02-28$1,635,838
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-02-28No
Was there a failure to transmit to the plan any participant contributions2017-02-28No
Has the plan failed to provide any benefit when due under the plan2017-02-28No
Contributions received in cash from employer2017-02-28$1,635,838
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-02-28No
Did the plan have assets held for investment2017-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-02-28No
2016 : ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-02-29$1,576,960
Total of all expenses incurred2016-02-29$1,576,960
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-02-29$1,576,960
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-02-29$1,576,960
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-02-29No
Was this plan covered by a fidelity bond2016-02-29No
If this is an individual account plan, was there a blackout period2016-02-29No
Were there any nonexempt tranactions with any party-in-interest2016-02-29No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-29No
Value of net income/loss2016-02-29$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2016-02-29No
Were any leases to which the plan was party in default or uncollectible2016-02-29No
Expenses. Payments to insurance carriers foe the provision of benefits2016-02-29$1,576,960
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-02-29No
Was there a failure to transmit to the plan any participant contributions2016-02-29No
Has the plan failed to provide any benefit when due under the plan2016-02-29No
Contributions received in cash from employer2016-02-29$1,576,960
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-02-29No
Did the plan have assets held for investment2016-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-02-29No

Form 5500 Responses for ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN

2023: ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2023 form 5500 responses
2023-03-01Type of plan entitySingle employer plan
2023-03-01Plan funding arrangement – General assets of the sponsorYes
2023-03-01Plan benefit arrangement – InsuranceYes
2022: ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Plan funding arrangement – General assets of the sponsorYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Plan funding arrangement – General assets of the sponsorYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Plan funding arrangement – General assets of the sponsorYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Plan funding arrangement – General assets of the sponsorYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – General assets of the sponsorYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Plan funding arrangement – General assets of the sponsorYes
2017-03-01Plan benefit arrangement – InsuranceYes
2016: ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01Plan funding arrangement – General assets of the sponsorYes
2016-03-01Plan benefit arrangement – InsuranceYes
2015: ULTIMATE HYDROFORMING, INC. EMPLOYEE'S HEALTH & DENTAL PLAN 2015 form 5500 responses
2015-03-01Type of plan entitySingle employer plan
2015-03-01First time form 5500 has been submittedYes
2015-03-01Plan funding arrangement – General assets of the sponsorYes
2015-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10214011001
Policy instance 5
Insurance contract or identification number10214011001
Number of Individuals Covered323
Insurance policy start date2023-03-01
Insurance policy end date2024-02-28
Total amount of commissions paid to insurance brokerUSD $1,598
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1124639
Policy instance 4
Insurance contract or identification number1124639
Number of Individuals Covered156
Insurance policy start date2023-03-01
Insurance policy end date2024-02-28
Total amount of commissions paid to insurance brokerUSD $10,105
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001955
Policy instance 3
Insurance contract or identification number0001955
Number of Individuals Covered333
Insurance policy start date2023-03-01
Insurance policy end date2024-02-28
Total amount of commissions paid to insurance brokerUSD $9,742
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 )
Policy contract number10005465
Policy instance 2
Insurance contract or identification number10005465
Number of Individuals Covered16
Insurance policy start date2023-03-01
Insurance policy end date2024-02-28
Total amount of commissions paid to insurance brokerUSD $9,025
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $225,621
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 )
Policy contract number10005464
Policy instance 1
Insurance contract or identification number10005464
Number of Individuals Covered307
Insurance policy start date2023-03-01
Insurance policy end date2024-02-28
Total amount of commissions paid to insurance brokerUSD $78,095
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,952,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 )
Policy contract number10005464
Policy instance 1
Insurance contract or identification number10005464
Number of Individuals Covered321
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $68,572
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,714,290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 )
Policy contract number10005465
Policy instance 2
Insurance contract or identification number10005465
Number of Individuals Covered18
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $7,815
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $195,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001955
Policy instance 3
Insurance contract or identification number0001955
Number of Individuals Covered339
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $5,672
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1124639
Policy instance 4
Insurance contract or identification number1124639
Number of Individuals Covered156
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $9,295
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10214011001
Policy instance 5
Insurance contract or identification number10214011001
Number of Individuals Covered339
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $2,174
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10214011001
Policy instance 5
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1124639
Policy instance 4
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001955
Policy instance 3
ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 )
Policy contract number10005465
Policy instance 2
HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 )
Policy contract number10005464
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10214011001
Policy instance 5
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1124639
Policy instance 4
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001955
Policy instance 3
ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 )
Policy contract number10005465
Policy instance 2
HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 )
Policy contract number10005464
Policy instance 1
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number158560
Policy instance 1
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number158560
Policy instance 2
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001955
Policy instance 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number200227
Policy instance 4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10214011001
Policy instance 5
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number158560
Policy instance 2
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number158560
Policy instance 1
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001955
Policy instance 3
ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 )
Policy contract number10004280
Policy instance 1
HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 )
Policy contract number10000967
Policy instance 2
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001955
Policy instance 3
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001955
Policy instance 3
HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 )
Policy contract number10000967
Policy instance 2
ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 )
Policy contract number10004280
Policy instance 1

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