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VOLUNTARY ACCIDENT INSURANCE PLAN 401k Plan overview

Plan NameVOLUNTARY ACCIDENT INSURANCE PLAN
Plan identification number 542

VOLUNTARY ACCIDENT INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

MUTUAL OF OMAHA INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:MUTUAL OF OMAHA INSURANCE COMPANY
Employer identification number (EIN):470246511
NAIC Classification:524140

Additional information about MUTUAL OF OMAHA INSURANCE COMPANY

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C0087163

More information about MUTUAL OF OMAHA INSURANCE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VOLUNTARY ACCIDENT INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5422018-01-01
5422017-06-01ROBERT FOLEY ROBERT FOLEY2018-07-23

Plan Statistics for VOLUNTARY ACCIDENT INSURANCE PLAN

401k plan membership statisitcs for VOLUNTARY ACCIDENT INSURANCE PLAN

Measure Date Value
2018: VOLUNTARY ACCIDENT INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,017
Total number of active participants reported on line 7a of the Form 55002018-01-011,047
Total of all active and inactive participants2018-01-011,047
Total participants2018-01-011,047
2017: VOLUNTARY ACCIDENT INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01778
Total number of active participants reported on line 7a of the Form 55002017-06-01801
Total of all active and inactive participants2017-06-01801
Total participants2017-06-01801

Form 5500 Responses for VOLUNTARY ACCIDENT INSURANCE PLAN

2018: VOLUNTARY ACCIDENT INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingYes
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: VOLUNTARY ACCIDENT INSURANCE PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01First time form 5500 has been submittedYes
2017-06-01Submission has been amendedNo
2017-06-01This submission is the final filingNo
2017-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-06-01Plan is a collectively bargained planNo
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000EH10
Policy instance 1
Insurance contract or identification numberG000EH10
Number of Individuals Covered1047
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 BenefitNo
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
Other welfare benefits providedVOLUNTARY ACCIDENT INSURANCE
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 $200,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000EH10
Policy instance 1
Insurance contract or identification numberG000EH10
Number of Individuals Covered801
Insurance policy start date2017-06-01
Insurance policy end date2017-12-31
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 BenefitNo
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
Other welfare benefits providedVOLUNTARY ACCIDENT INSURANCE
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 $89,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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