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ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan NameASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN
Plan identification number 501

ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

ASCENSUS SPECIALTIES LLC has sponsored the creation of one or more 401k plans.

Company Name:ASCENSUS SPECIALTIES LLC
Employer identification number (EIN):472301200
NAIC Classification:325900
NAIC Description:Other Chemical Product and Preparation Manufacturing

Additional information about ASCENSUS SPECIALTIES LLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 2015-01-09
Company Identification Number: 603466663
Legal Registered Office Address: 300 DESCHUTES WAY SW STE 304

TUMWATER
United States of America (USA)
98501

More information about ASCENSUS SPECIALTIES LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01LEAH BOYLE2024-06-28
5012022-01-01LEAH BOYLE2023-05-31

Plan Statistics for ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN

Measure Date Value
2023: ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01239
Total number of active participants reported on line 7a of the Form 55002023-01-01216
Number of retired or separated participants receiving benefits2023-01-0110
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01226
Number of employers contributing to the scheme2023-01-010
2022: ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01222
Total number of active participants reported on line 7a of the Form 55002022-01-01231
Number of retired or separated participants receiving benefits2022-01-018
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01239
Number of employers contributing to the scheme2022-01-010

Form 5500 Responses for ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN

2023: ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: ASCENSUS SPECIALTIES LLC EMPLOYEE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01First time form 5500 has been submittedYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607818
Policy instance 5
Insurance contract or identification numberSGM607818
Number of Individuals Covered216
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $35,419
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $417,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number537361
Policy instance 4
Insurance contract or identification number537361
Number of Individuals Covered75
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $7,116
Total amount of fees paid to insurance companyUSD $869
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $43,844
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: 53031 )
Policy contract number30100661
Policy instance 3
Insurance contract or identification number30100661
Number of Individuals Covered208
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,991
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 32519 )
Policy contract number00
Policy instance 2
Insurance contract or identification number00
Number of Individuals Covered252
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $6,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number3885
Policy instance 1
Insurance contract or identification number3885
Number of Individuals Covered545
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $11,001
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607818
Policy instance 5
Insurance contract or identification numberSGM607818
Number of Individuals Covered84
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $27,267
Total amount of fees paid to insurance companyUSD $3,986
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $272,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,267
Amount paid for insurance broker fees3986
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number537361
Policy instance 4
Insurance contract or identification number537361
Number of Individuals Covered80
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $10,643
Total amount of fees paid to insurance companyUSD $1,915
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $41,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,643
Amount paid for insurance broker fees1915
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30100661
Policy instance 3
Insurance contract or identification number30100661
Number of Individuals Covered212
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,090
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,090
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 32519 )
Policy contract number00
Policy instance 2
Insurance contract or identification number00
Number of Individuals Covered231
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $5,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number631033
Policy instance 1
Insurance contract or identification number631033
Number of Individuals Covered237
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $10,108
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $204,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,108
Amount paid for insurance broker fees0
Insurance broker organization code?3

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