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HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 401k Plan overview

Plan NameHEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE
Plan identification number 501

HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE Benefits

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

401k Sponsoring company profile

JEFFERSON ENERGY COOPERATIVE has sponsored the creation of one or more 401k plans.

Company Name:JEFFERSON ENERGY COOPERATIVE
Employer identification number (EIN):580303365
NAIC Classification:221100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01WAYNE GOSSAGE
5012023-01-01
5012023-01-01WAYNE GOSSAGE
5012022-01-01
5012022-01-01CHRIS DILLARD
5012021-01-01
5012021-01-01CHRIS DILLARD
5012020-01-01
5012019-01-01
5012018-01-01CHRIS DILLARD
5012017-01-01CHRIS DILLARD
5012016-01-01CHRIS DILLARD
5012015-01-01CHRIS DILLARD

Form 5500 Responses for HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE

2023: HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 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: HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 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: HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 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: HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 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: HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 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: HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 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: HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 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: HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: HEALTH INSURANCE PLAN FOR EMPLOYEES OF JEFFERSON ENERGY COOPERATIVE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00511340
Policy instance 2
Insurance contract or identification number00511340
Number of Individuals Covered82
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $3,692
Total amount of fees paid to insurance companyUSD $687
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL40383
Policy instance 1
Insurance contract or identification numberHCL40383
Number of Individuals Covered118
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $406,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00511340
Policy instance 3
Insurance contract or identification number00511340
Number of Individuals Covered77
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,548
Total amount of fees paid to insurance companyUSD $524
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22276 )
Policy contract number47-MSL-000639-0
Policy instance 2
Insurance contract or identification number47-MSL-000639-0
Number of Individuals Covered113
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Welfare Benefit Premiums Paid to CarrierUSD $276,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number
Policy instance 1
Number of Individuals Covered113
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00511340
Policy instance 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number939604
Policy instance 2
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number
Policy instance 1
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number
Policy instance 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number939604
Policy instance 2
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberG0386
Policy instance 1
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberG0386
Policy instance 1
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberG0386
Policy instance 1
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberG0386
Policy instance 1
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberG0386
Policy instance 1

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