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SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN 401k Plan overview

Plan NameSCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN
Plan identification number 501

SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

SCULL CONSTRUCTION SERVICE INC. has sponsored the creation of one or more 401k plans.

Company Name:SCULL CONSTRUCTION SERVICE INC.
Employer identification number (EIN):460386588
NAIC Classification:236200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01ANDREW J SCULL
5012023-01-01
5012023-01-01ANDREW J SCULL
5012022-01-01
5012022-01-01ANDREW J SCULL
5012021-01-01
5012021-01-01ANDREW J SCULL
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01ANDREW J SCULL ANDREW J SCULL2018-07-06
5012016-01-01ANDREW J SCULL ANDREW J SCULL2017-05-31

Form 5500 Responses for SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN

2023: SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: SCULL CONSTRUCTION SERVICE HEALTHCARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number0GL-921745
Policy instance 5
Insurance contract or identification number0GL-921745
Insurance policy start date2023-09-01
Insurance policy end date2023-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number2736
Policy instance 4
Insurance contract or identification number2736
Number of Individuals Covered188
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,622
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30069443
Policy instance 3
Insurance contract or identification number30069443
Number of Individuals Covered89
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $890
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,837
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 number1068053
Policy instance 2
Insurance contract or identification number1068053
Number of Individuals Covered211
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $5,245
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 )
Policy contract numberHP001229
Policy instance 1
Insurance contract or identification numberHP001229
Number of Individuals Covered231
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $20,232
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,281,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number2736
Policy instance 4
Insurance contract or identification number2736
Number of Individuals Covered180
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,572
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30069443
Policy instance 3
Insurance contract or identification number30069443
Number of Individuals Covered77
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $827
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 )
Policy contract numberHP001229
Policy instance 1
Insurance contract or identification numberHP001229
Number of Individuals Covered235
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $19,526
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,219,246
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 number1068053
Policy instance 2
Insurance contract or identification number1068053
Number of Individuals Covered198
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $5,058
Total amount of fees paid to insurance companyUSD $576
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30069443
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30072226
Policy instance 4
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number2736
Policy instance 5
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1073110
Policy instance 6
SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 )
Policy contract numberHP001229
Policy instance 7
SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 )
Policy contract numberHP001382
Policy instance 1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068053
Policy instance 2
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068053
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30069443
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30072226
Policy instance 4
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number2736
Policy instance 5
AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 )
Policy contract numberSD138
Policy instance 1
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number9070-316
Policy instance 6
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1073110
Policy instance 7
SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 )
Policy contract numberHP001229
Policy instance 8
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068053
Policy instance 3
SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 )
Policy contract numberHP001229
Policy instance 9
AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 )
Policy contract numberSD993
Policy instance 1
AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 )
Policy contract numberSD138
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30069443
Policy instance 4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30072226
Policy instance 5
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number2736
Policy instance 6
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number9070-316
Policy instance 7
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1073110
Policy instance 8
AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 )
Policy contract numberSD993
Policy instance 1
AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 )
Policy contract numberSD138
Policy instance 2
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068053
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30069443
Policy instance 4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30072226
Policy instance 5
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number2736
Policy instance 6
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number9070-316
Policy instance 7
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1073110
Policy instance 8
AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 )
Policy contract numberSD138
Policy instance 2
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068053
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30069443
Policy instance 4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30072226
Policy instance 5
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number2736
Policy instance 6
DELTA DENTAL OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 54097 )
Policy contract number9070-316
Policy instance 7
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1073110
Policy instance 8
AVERA HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95839 )
Policy contract numberSD993
Policy instance 1

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