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BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 401k Plan overview

Plan NameBULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN
Plan identification number 501

BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

BULAB HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name:BULAB HOLDINGS, INC.
Employer identification number (EIN):620438397
NAIC Classification:325900
NAIC Description:Other Chemical Product and Preparation Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-01-01CARLA BRADLEY2020-08-18
5012019-01-01ROLANA BOURLAND2021-08-31
5012018-01-01CARLA BRADLEY2019-10-04
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01CARLA J. BRADLEY
5012011-01-01CARLA J. BRADLEY
5012010-01-01CARLA J. BRADLEY
5012009-01-01CARLA J. BRADLEY

Plan Statistics for BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN

401k plan membership statisitcs for BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN

Measure Date Value
2019: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01519
Total number of active participants reported on line 7a of the Form 55002019-01-01504
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01504
Number of employers contributing to the scheme2019-01-010
2018: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01581
Total number of active participants reported on line 7a of the Form 55002018-01-01515
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01515
Number of employers contributing to the scheme2018-01-010
2017: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01495
Total number of active participants reported on line 7a of the Form 55002017-01-01479
Number of retired or separated participants receiving benefits2017-01-0128
Total of all active and inactive participants2017-01-01507
2016: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01631
Total number of active participants reported on line 7a of the Form 55002016-01-01466
Number of retired or separated participants receiving benefits2016-01-0129
Total of all active and inactive participants2016-01-01495
2015: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01629
Total number of active participants reported on line 7a of the Form 55002015-01-01469
Number of retired or separated participants receiving benefits2015-01-01162
Total of all active and inactive participants2015-01-01631
2014: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01498
Total number of active participants reported on line 7a of the Form 55002014-01-01466
Number of retired or separated participants receiving benefits2014-01-01163
Total of all active and inactive participants2014-01-01629
2013: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01468
Total number of active participants reported on line 7a of the Form 55002013-01-01498
Total of all active and inactive participants2013-01-01498
2012: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01484
Total number of active participants reported on line 7a of the Form 55002012-01-01468
Total of all active and inactive participants2012-01-01468
2011: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01499
Total number of active participants reported on line 7a of the Form 55002011-01-01484
Total of all active and inactive participants2011-01-01484
2010: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01544
Total number of active participants reported on line 7a of the Form 55002010-01-01499
Total of all active and inactive participants2010-01-01499
2009: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01599
Total number of active participants reported on line 7a of the Form 55002009-01-01544
Total of all active and inactive participants2009-01-01544

Form 5500 Responses for BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN

2019: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01This submission is the final filingYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: BULAB HOSPITALIZATION, SURGICAL, & MAJOR MEDICAL INSURANCE AND SHORT TERM DISABILITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number621503
Policy instance 1
Insurance contract or identification number621503
Number of Individuals Covered515
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLONG TERM CARE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number621503
Policy instance 1
Insurance contract or identification number621503
Number of Individuals Covered3
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $3,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number621503
Policy instance 1
Insurance contract or identification number621503
Number of Individuals Covered3
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $3,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number621503
Policy instance 1
Insurance contract or identification number621503
Number of Individuals Covered3
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedLONGTERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $3,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478989-SL
Policy instance 1
Insurance contract or identification number478989-SL
Number of Individuals Covered492
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $54,232
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $685,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,784
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478989-SL
Policy instance 1
Insurance contract or identification number478989-SL
Number of Individuals Covered1410
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $49,614
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $624,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,614
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478989
Policy instance 1
Insurance contract or identification number478989
Number of Individuals Covered484
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $44,478
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $558,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number478989
Policy instance 1
Insurance contract or identification number478989
Number of Individuals Covered499
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $42,048
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $526,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,048
Insurance broker nameAON RISK SERVICES, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number621503
Policy instance 2
Insurance contract or identification number621503
Number of Individuals Covered4
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedLONGTERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $4,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameN/A

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