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OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameOX PAPER TUBE & CORE HEALTH AND WELFARE PLAN
Plan identification number 501

OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

OX PAPER TUBE & CORE, LLC has sponsored the creation of one or more 401k plans.

Company Name:OX PAPER TUBE & CORE, LLC
Employer identification number (EIN):465660730
NAIC Classification:322200

Additional information about OX PAPER TUBE & CORE, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2018-01-17
Company Identification Number: 0802915237
Legal Registered Office Address: 600 W ELM AVE

HANOVER
United States of America (USA)
17331

More information about OX PAPER TUBE & CORE, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-07-01AMANDA HARTLAUB2020-11-09
5012018-07-01AMANDA HARTLAUB2019-12-02
5012018-07-01AMANDA HARTLAUB2021-12-03
5012017-07-01AMANDA HARTLAUB2019-12-02
5012016-07-01AMANDA HARTLAUB2019-12-02

Plan Statistics for OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN

401k plan membership statisitcs for OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN

Measure Date Value
2019: OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01252
Total number of active participants reported on line 7a of the Form 55002019-07-01266
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01266
Number of employers contributing to the scheme2019-07-010
2018: OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01212
Total number of active participants reported on line 7a of the Form 55002018-07-01252
Number of retired or separated participants receiving benefits2018-07-011
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01253
Number of employers contributing to the scheme2018-07-010
2017: OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01205
Total number of active participants reported on line 7a of the Form 55002017-07-01212
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01212
Number of employers contributing to the scheme2017-07-010
2016: OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01185
Total number of active participants reported on line 7a of the Form 55002016-07-01199
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01199
Number of employers contributing to the scheme2016-07-010

Form 5500 Responses for OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN

2019: OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedYes
2018-07-01This submission is the final filingYes
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: OX PAPER TUBE & CORE HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01First time form 5500 has been submittedYes
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number102203
Policy instance 1
Insurance contract or identification number102203
Number of Individuals Covered549
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $2,084
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,084
Amount paid for insurance broker fees0
Insurance broker organization code?3
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number700128
Policy instance 2
Insurance contract or identification number700128
Number of Individuals Covered112
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $35,256
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,256
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number911679
Policy instance 3
Insurance contract or identification number911679
Number of Individuals Covered109
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $5,090
Total amount of fees paid to insurance companyUSD $965
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,137
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,090
Amount paid for insurance broker fees965
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BKKL
Policy instance 4
Insurance contract or identification numberGLUG0BKKL
Number of Individuals Covered124
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $4,937
Total amount of fees paid to insurance companyUSD $1,021
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $32,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,937
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number02527740
Policy instance 1
Insurance contract or identification number02527740
Number of Individuals Covered532
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $1,815
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,815
Amount paid for insurance broker fees0
Insurance broker organization code?3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number02527740
Policy instance 1
Insurance contract or identification number02527740
Number of Individuals Covered422
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $3
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,918
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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