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GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 401k Plan overview

Plan NameGROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE
Plan identification number 505

GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 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)

401k Sponsoring company profile

PETERSBURG MOTOR COMPANY has sponsored the creation of one or more 401k plans.

Company Name:PETERSBURG MOTOR COMPANY
Employer identification number (EIN):540338910
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052021-09-01RICK CROIZIER2023-02-15
5052020-09-01BRANDON AMBROSE2021-12-24
5052019-09-01BRANDON J AMBROSE2021-03-18
5052018-09-01CANDRA KENYON2020-02-18
5052017-09-01CANDRA KENYON

Plan Statistics for GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE

401k plan membership statisitcs for GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE

Measure Date Value
2021: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2021 401k membership
Total participants, beginning-of-year2021-09-01598
Total number of active participants reported on line 7a of the Form 55002021-09-01826
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01826
Number of employers contributing to the scheme2021-09-010
2020: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2020 401k membership
Total participants, beginning-of-year2020-09-01569
Total number of active participants reported on line 7a of the Form 55002020-09-01592
Number of retired or separated participants receiving benefits2020-09-016
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01598
Number of employers contributing to the scheme2020-09-010
2019: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2019 401k membership
Total participants, beginning-of-year2019-09-01310
Total number of active participants reported on line 7a of the Form 55002019-09-01569
Number of retired or separated participants receiving benefits2019-09-010
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-01569
Number of employers contributing to the scheme2019-09-010
2018: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2018 401k membership
Total participants, beginning-of-year2018-09-01378
Total number of active participants reported on line 7a of the Form 55002018-09-01310
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01310
Number of employers contributing to the scheme2018-09-010
2017: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2017 401k membership
Total participants, beginning-of-year2017-09-01361
Total number of active participants reported on line 7a of the Form 55002017-09-01480
Total of all active and inactive participants2017-09-01480

Form 5500 Responses for GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE

2021: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan funding arrangement – General assets of the sponsorYes
2021-09-01Plan benefit arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – General assets of the sponsorYes
2020: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan funding arrangement – General assets of the sponsorYes
2020-09-01Plan benefit arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – General assets of the sponsorYes
2019: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
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: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: GROUP SHORT TERM DISABILITY PLAN OF PETERSBURG MOTOR COMPANY DBA CARTER MYERS AUTOMOTIVE 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01First time form 5500 has been submittedYes
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)No
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number29660
Policy instance 4
Insurance contract or identification number29660
Number of Individuals Covered588
Insurance policy start date2021-09-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $22,124
Total amount of fees paid to insurance companyUSD $0
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 providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $84,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $22,124
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberACC-0000151032
Policy instance 3
Insurance contract or identification numberACC-0000151032
Number of Individuals Covered826
Insurance policy start date2022-04-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 providedACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $34,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number888624G
Policy instance 2
Insurance contract or identification number888624G
Number of Individuals Covered826
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $93,657
Total amount of fees paid to insurance companyUSD $4,139
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $615,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $93,657
Amount paid for insurance broker fees4139
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-57086
Policy instance 1
Insurance contract or identification number10-57086
Number of Individuals Covered1089
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $5,259
Total amount of fees paid to insurance companyUSD $1,226
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,259
Amount paid for insurance broker fees1226
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number29660
Policy instance 3
Insurance contract or identification number29660
Number of Individuals Covered342
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $30,310
Total amount of fees paid to insurance companyUSD $0
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 providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $96,871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,310
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number888624G
Policy instance 2
Insurance contract or identification number888624G
Number of Individuals Covered592
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $75,181
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $484,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75,181
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1007166 ET AL
Policy instance 1
Insurance contract or identification number1007166 ET AL
Number of Individuals Covered608
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $4,159
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,159
Amount paid for insurance broker fees0
Insurance broker organization code?3
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )
Policy contract number29660
Policy instance 3
Insurance contract or identification number29660
Number of Individuals Covered252
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $33,490
Total amount of fees paid to insurance companyUSD $107
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $84,470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $32,043
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number888624G
Policy instance 2
Insurance contract or identification number888624G
Number of Individuals Covered569
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $52,895
Total amount of fees paid to insurance companyUSD $20,333
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $374,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,895
Amount paid for insurance broker fees20333
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1007166 ET AL
Policy instance 1
Insurance contract or identification number1007166 ET AL
Number of Individuals Covered544
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $4,846
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,846
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967995
Policy instance 3
Insurance contract or identification numberFLX967995
Number of Individuals Covered310
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $44,279
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 $295,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $32,125
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE - FIDELITY SECURITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10071661001
Policy instance 2
Insurance contract or identification number10071661001
Number of Individuals Covered534
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $3,465
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,702
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3341138
Policy instance 1
Insurance contract or identification number3341138
Number of Individuals Covered729
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $69,739
Total amount of fees paid to insurance companyUSD $2,100
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $575,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $47,414
Amount paid for insurance broker fees2100
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT FEES
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK752212
Policy instance 1
Insurance contract or identification numberLK752212
Number of Individuals Covered428
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $10,395
Total amount of fees paid to insurance companyUSD $3,340
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 BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $69,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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