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QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 401k Plan overview

Plan NameQBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN
Plan identification number 503

QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover

401k Sponsoring company profile

QBE OPTIMA INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:QBE OPTIMA INSURANCE COMPANY
Employer identification number (EIN):660648224
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-04-01
5032021-04-01ROSA IVONNE OTERO
5032016-09-01ROSA IVONNE OTERO ROSA IVONNE OTERO2018-02-22
5032015-09-01ROSA IVONNE OTERO ROSA IVONNE OTERO2017-03-06
5032014-09-01ROSA IVONNE OTERO ROSA IVONNE OTERO2016-06-15
5032013-09-01ROSA IVONNE OTERO ROSA IVONNE OTERO2015-06-12

Plan Statistics for QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN

401k plan membership statisitcs for QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN

Measure Date Value
2021: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-0195
Total number of active participants reported on line 7a of the Form 55002021-04-01100
Total of all active and inactive participants2021-04-01100
Total participants2021-04-01100
2016: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01149
Total number of active participants reported on line 7a of the Form 55002016-09-01113
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01113
2015: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01152
Total number of active participants reported on line 7a of the Form 55002015-09-01149
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-01149
2014: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01147
Total number of active participants reported on line 7a of the Form 55002014-09-01152
Number of retired or separated participants receiving benefits2014-09-010
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-01152
2013: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01147
Total number of active participants reported on line 7a of the Form 55002013-09-01147
Number of retired or separated participants receiving benefits2013-09-010
Number of other retired or separated participants entitled to future benefits2013-09-010
Total of all active and inactive participants2013-09-01147

Form 5500 Responses for QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN

2021: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2016: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: QBE OPTIMA INSURANCE COMPANY WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01First time form 5500 has been submittedYes
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

FIRST MEDICAL HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95722 )
Policy contract number2439
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD604438
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606548
Policy instance 2
PAN AMERICAN LIFE INSURANCE GROUP (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract number88626
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD604438
Policy instance 3
MULTINATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72087 )
Policy contract number1-4294-000
Policy instance 2
MCS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60030 )
Policy contract number79-790909
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD604438
Policy instance 3
USIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11067 )
Policy contract numberGPL-000036
Policy instance 2
MCS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60030 )
Policy contract number79-790909
Policy instance 1

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