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FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameFLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN
Plan identification number 504

FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

FLOE INTERNATIONAL, INC. has sponsored the creation of one or more 401k plans.

Company Name:FLOE INTERNATIONAL, INC.
Employer identification number (EIN):411746832
NAIC Classification:331310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042019-09-01SUSAN ANDERSON2021-04-09
5042018-09-01SUSAN ANDERSON2020-01-21

Plan Statistics for FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN

Measure Date Value
2019: FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01180
Total number of active participants reported on line 7a of the Form 55002019-09-010
Total of all active and inactive participants2019-09-010
2018: FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01196
Total number of active participants reported on line 7a of the Form 55002018-09-01180
Total of all active and inactive participants2018-09-01180

Form 5500 Responses for FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN

2019: FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01This submission is the final filingYes
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan funding arrangement – General assets of the sponsorYes
2019-09-01Plan benefit arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – General assets of the sponsorYes
2018: FLOE INTERNATIONAL, INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01First time form 5500 has been submittedYes
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan funding arrangement – General assets of the sponsorYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

ALLIED BENEFIT SYSTEMS (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberL192456
Policy instance 5
Insurance contract or identification numberL192456
Number of Individuals Covered1
Insurance policy start date2019-09-01
Insurance policy end date2020-08-30
Total amount of commissions paid to insurance brokerUSD $27,273
Total amount of fees paid to insurance companyUSD $78,438
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,596
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees78438
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $27,273
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number611537
Policy instance 4
Insurance contract or identification number611537
Number of Individuals Covered139
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $576
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $569
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0B73S
Policy instance 3
Insurance contract or identification numberGVTL0B73S
Number of Individuals Covered62
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $1,461
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLIFE & AD&D VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $14,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,461
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUD 0B73S
Policy instance 2
Insurance contract or identification numberGUD 0B73S
Number of Individuals Covered140
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $2,760
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,760
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B73S
Policy instance 1
Insurance contract or identification numberGLUG0B73S
Number of Individuals Covered144
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $935
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $935
Insurance broker organization code?3
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000679583
Policy instance 5
Insurance contract or identification number0000679583
Number of Individuals Covered136
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $972
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $972
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0B73S
Policy instance 4
Insurance contract or identification numberGVTL0B73S
Number of Individuals Covered51
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $1,430
Total amount of fees paid to insurance companyUSD $1,416
Other welfare benefits providedLIFE & AD&D VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $14,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,323
Amount paid for insurance broker fees944
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUD 0B73S
Policy instance 3
Insurance contract or identification numberGUD 0B73S
Number of Individuals Covered180
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $2,745
Total amount of fees paid to insurance companyUSD $2,007
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,543
Amount paid for insurance broker fees1338
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B73S
Policy instance 2
Insurance contract or identification numberGLUG0B73S
Number of Individuals Covered142
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $1,018
Total amount of fees paid to insurance companyUSD $1,090
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $10,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $941
Amount paid for insurance broker fees727
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
PREFERREDONE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11817 )
Policy contract numberPCH10360
Policy instance 1
Insurance contract or identification numberPCH10360
Number of Individuals Covered127
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $44,488
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $860,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,324
Insurance broker organization code?3

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