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HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 401k Plan overview

Plan NameHOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY
Plan identification number 503

HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

NATIONAL RIVET & MANUFACTURING CO. has sponsored the creation of one or more 401k plans.

Company Name:NATIONAL RIVET & MANUFACTURING CO.
Employer identification number (EIN):390494280
NAIC Classification:332700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032018-02-01
5032017-02-01FRANCIS CYR JOHN BUR ZERATSKY2018-08-28
5032016-02-01FRANCIS CYR JOHN BUR ZERATSKY2017-08-24
5032015-02-01FRANCIS CYR JOHN BUR ZERATSKY2016-08-31
5032014-02-01FRANCIS CYR JOHN BUR ZERATSKY2015-08-26
5032013-02-01FRANCIS CYR JOHN BUR ZERATSKY2014-08-29
5032012-02-01FRANCIS CYR JOHN BUR ZERATSKY2013-08-29
5032011-02-01JOHN BUR ZERATSKY FRANCIS CYR2012-08-30
5032010-02-01FRANCIS CYR JOHN BUR ZERATSKY2011-08-25
5032009-02-01FRANCIS CYR JOHN BUR ZERATSKY2010-08-16

Plan Statistics for HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY

401k plan membership statisitcs for HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY

Measure Date Value
2018: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2018 401k membership
Total participants, beginning-of-year2018-02-0166
Total number of active participants reported on line 7a of the Form 55002018-02-0165
Number of retired or separated participants receiving benefits2018-02-011
Total of all active and inactive participants2018-02-0166
Total participants2018-02-0166
2017: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2017 401k membership
Total participants, beginning-of-year2017-02-0168
Total number of active participants reported on line 7a of the Form 55002017-02-0162
Number of retired or separated participants receiving benefits2017-02-011
Total of all active and inactive participants2017-02-0163
Total participants2017-02-0163
2016: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2016 401k membership
Total participants, beginning-of-year2016-02-0172
Total number of active participants reported on line 7a of the Form 55002016-02-0166
Number of retired or separated participants receiving benefits2016-02-013
Total of all active and inactive participants2016-02-0169
Total participants2016-02-0169
2015: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2015 401k membership
Total participants, beginning-of-year2015-02-0180
Total number of active participants reported on line 7a of the Form 55002015-02-0165
Number of retired or separated participants receiving benefits2015-02-019
Total of all active and inactive participants2015-02-0174
Total participants2015-02-0174
2014: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2014 401k membership
Total participants, beginning-of-year2014-02-0178
Total number of active participants reported on line 7a of the Form 55002014-02-0167
Number of retired or separated participants receiving benefits2014-02-0110
Total of all active and inactive participants2014-02-0177
Total participants2014-02-0177
2013: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2013 401k membership
Total participants, beginning-of-year2013-02-0174
Total number of active participants reported on line 7a of the Form 55002013-02-0161
Number of retired or separated participants receiving benefits2013-02-0111
Total of all active and inactive participants2013-02-0172
Total participants2013-02-0172
Number of employers contributing to the scheme2013-02-0172
2012: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2012 401k membership
Total participants, beginning-of-year2012-02-0176
Total number of active participants reported on line 7a of the Form 55002012-02-0162
Number of retired or separated participants receiving benefits2012-02-0112
Total of all active and inactive participants2012-02-0174
Total participants2012-02-0174
Number of employers contributing to the scheme2012-02-0174
2011: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2011 401k membership
Total participants, beginning-of-year2011-02-0177
Total number of active participants reported on line 7a of the Form 55002011-02-0162
Number of retired or separated participants receiving benefits2011-02-0113
Total of all active and inactive participants2011-02-0175
Total participants2011-02-0175
Number of employers contributing to the scheme2011-02-0175
2010: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2010 401k membership
Total participants, beginning-of-year2010-02-0179
Total number of active participants reported on line 7a of the Form 55002010-02-0163
Number of retired or separated participants receiving benefits2010-02-0114
Total of all active and inactive participants2010-02-0177
Total participants2010-02-0177
2009: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2009 401k membership
Total participants, beginning-of-year2009-02-01101
Total number of active participants reported on line 7a of the Form 55002009-02-0164
Number of retired or separated participants receiving benefits2009-02-0115
Number of other retired or separated participants entitled to future benefits2009-02-010
Total of all active and inactive participants2009-02-0179
Total participants2009-02-0179

Form 5500 Responses for HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY

2018: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Submission has been amendedNo
2018-02-01This submission is the final filingNo
2018-02-01This return/report is a short plan year return/report (less than 12 months)No
2018-02-01Plan is a collectively bargained planNo
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – InsuranceYes
2017: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planNo
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Submission has been amendedNo
2016-02-01This submission is the final filingNo
2016-02-01This return/report is a short plan year return/report (less than 12 months)No
2016-02-01Plan is a collectively bargained planNo
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – InsuranceYes
2015: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Submission has been amendedNo
2015-02-01This submission is the final filingNo
2015-02-01This return/report is a short plan year return/report (less than 12 months)No
2015-02-01Plan is a collectively bargained planNo
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – InsuranceYes
2014: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01Submission has been amendedNo
2014-02-01This submission is the final filingNo
2014-02-01This return/report is a short plan year return/report (less than 12 months)No
2014-02-01Plan is a collectively bargained planNo
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan benefit arrangement – InsuranceYes
2013: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2013 form 5500 responses
2013-02-01Type of plan entitySingle employer plan
2013-02-01Submission has been amendedNo
2013-02-01This submission is the final filingNo
2013-02-01This return/report is a short plan year return/report (less than 12 months)No
2013-02-01Plan is a collectively bargained planNo
2013-02-01Plan funding arrangement – InsuranceYes
2013-02-01Plan benefit arrangement – InsuranceYes
2012: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2012 form 5500 responses
2012-02-01Type of plan entitySingle employer plan
2012-02-01Submission has been amendedNo
2012-02-01This submission is the final filingNo
2012-02-01This return/report is a short plan year return/report (less than 12 months)No
2012-02-01Plan is a collectively bargained planNo
2012-02-01Plan funding arrangement – InsuranceYes
2012-02-01Plan benefit arrangement – InsuranceYes
2011: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2011 form 5500 responses
2011-02-01Type of plan entitySingle employer plan
2011-02-01Submission has been amendedNo
2011-02-01This submission is the final filingNo
2011-02-01This return/report is a short plan year return/report (less than 12 months)No
2011-02-01Plan is a collectively bargained planNo
2011-02-01Plan funding arrangement – InsuranceYes
2011-02-01Plan benefit arrangement – InsuranceYes
2010: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2010 form 5500 responses
2010-02-01Type of plan entitySingle employer plan
2010-02-01Submission has been amendedNo
2010-02-01This submission is the final filingNo
2010-02-01This return/report is a short plan year return/report (less than 12 months)No
2010-02-01Plan is a collectively bargained planNo
2010-02-01Plan funding arrangement – InsuranceYes
2010-02-01Plan benefit arrangement – InsuranceYes
2009: HOSPITAL & SURGICAL BENEFIT FOR EMPLOYEES ON THE SHALER & NATIONAL RIVET & MFG COMPANY 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number1335
Policy instance 1
Insurance contract or identification number1335
Number of Individuals Covered136
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $13,356
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life 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
Welfare Benefit Premiums Paid to CarrierUSD $1,042,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,356
Insurance broker organization code?3
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number1335
Policy instance 1
Insurance contract or identification number1335
Number of Individuals Covered148
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $13,572
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life 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
Welfare Benefit Premiums Paid to CarrierUSD $1,061,563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,572
Insurance broker organization code?3
Insurance broker nameHAUSMANN-JOHNSON INSURANCE CO
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number1335
Policy instance 1
Insurance contract or identification number1335
Number of Individuals Covered165
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $15,504
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life 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
Welfare Benefit Premiums Paid to CarrierUSD $1,124,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,504
Insurance broker organization code?3
Insurance broker nameHAUSMANN-JOHNSON INSURANCE CO.
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number1335
Policy instance 1
Insurance contract or identification number1335
Number of Individuals Covered150
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $15,040
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life 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
Welfare Benefit Premiums Paid to CarrierUSD $1,011,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,040
Insurance broker organization code?3
Insurance broker nameHAUSMANN-JOHNSON INSURANCE CO.
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number13350-13355V
Policy instance 1
Insurance contract or identification number13350-13355V
Number of Individuals Covered149
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $13,886
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life 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
Welfare Benefit Premiums Paid to CarrierUSD $951,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,886
Insurance broker organization code?3
Insurance broker nameHAUSMANN-JOHNSON INSURANCE CO.
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number13350-13355V
Policy instance 1
Insurance contract or identification number13350-13355V
Number of Individuals Covered156
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $15,611
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $978,470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,611
Insurance broker organization code?3
Insurance broker nameHAUSMANN-JOHNSON INSURANCE INC.
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number13350-13355V
Policy instance 1
Insurance contract or identification number13350-13355V
Number of Individuals Covered158
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $15,661
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $890,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number13350-13355Q
Policy instance 1
Insurance contract or identification number13350-13355Q
Number of Individuals Covered163
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $16,388
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,013,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,388
Insurance broker organization code?3
Insurance broker nameHAUSMANN JOHNSON INSURANCE INC.

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