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COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN 401k Plan overview

Plan NameCOST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN
Plan identification number 502

COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • 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.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

COST OF WISCONSIN, INC. has sponsored the creation of one or more 401k plans.

Company Name:COST OF WISCONSIN, INC.
Employer identification number (EIN):391089478
NAIC Classification:238300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022020-01-01
5022019-01-01
5022017-01-01ROGER SCHRIEBER
5022016-01-01ROGER SCHRIEBER ROGER SCHRIEBER2017-07-27

Plan Statistics for COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN

401k plan membership statisitcs for COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN

Measure Date Value
2020: COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01106
Total number of active participants reported on line 7a of the Form 55002020-01-01101
Number of retired or separated participants receiving benefits2020-01-010
Total of all active and inactive participants2020-01-01101
Total participants2020-01-01101
2019: COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01104
Total number of active participants reported on line 7a of the Form 55002019-01-01100
Number of retired or separated participants receiving benefits2019-01-014
Total of all active and inactive participants2019-01-01104
2017: COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01126
Total number of active participants reported on line 7a of the Form 55002017-01-0166
Total of all active and inactive participants2017-01-0166
2016: COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01153
Total number of active participants reported on line 7a of the Form 55002016-01-01138
Total of all active and inactive participants2016-01-01138
Total participants2016-01-01138

Form 5500 Responses for COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN

2020: COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: COST OF WISCONSIN, INC. EMPLOYEE HEALTH CARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 23779 )
Policy contract numberC975
Policy instance 1
Insurance contract or identification numberC975
Number of Individuals Covered101
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $20,438
Total amount of fees paid to insurance companyUSD $40,002
Welfare Benefit Premiums Paid to CarrierUSD $507,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $-34
Amount paid for insurance broker fees40002
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberC975
Policy instance 1
Insurance contract or identification numberC975
Number of Individuals Covered81
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $48,737
Total amount of fees paid to insurance companyUSD $2,266
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $380,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,499
Amount paid for insurance broker fees2266
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
Insurance broker nameAUXIANT

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