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HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 401k Plan overview

Plan NameHARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN
Plan identification number 501

HARNESS ROOFING, INC. EMPLOYEE WELFARE 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

HARNESS ROOFING, INC. has sponsored the creation of one or more 401k plans.

Company Name:HARNESS ROOFING, INC.
Employer identification number (EIN):710654212
NAIC Classification:238100

Additional information about HARNESS ROOFING, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2005-06-01
Company Identification Number: 0800501896
Legal Registered Office Address: 415 S MAIN ST

HARRISON
United States of America (USA)
72601

More information about HARNESS ROOFING, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-09-01
5012018-09-01
5012017-09-01
5012016-09-01HOGANTAYLOR LLP PREPARER
5012015-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2017-06-15
5012014-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2016-03-28
5012013-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2016-01-20
5012012-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2016-01-20
5012011-09-01HOGANTAYLOR LLP PREPARER HOGANTAYLOR LLP PREPARER2016-02-03

Plan Statistics for HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN

401k plan membership statisitcs for HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN

Measure Date Value
2019: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01248
Total number of active participants reported on line 7a of the Form 55002019-09-01222
Number of retired or separated participants receiving benefits2019-09-011
Total of all active and inactive participants2019-09-01223
2018: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01286
Total number of active participants reported on line 7a of the Form 55002018-09-01285
Number of retired or separated participants receiving benefits2018-09-011
Total of all active and inactive participants2018-09-01286
2017: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01200
Total number of active participants reported on line 7a of the Form 55002017-09-01190
Number of retired or separated participants receiving benefits2017-09-011
Total of all active and inactive participants2017-09-01191
Total participants2017-09-01191
2016: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01142
Total number of active participants reported on line 7a of the Form 55002016-09-01191
Total of all active and inactive participants2016-09-01191
Total participants2016-09-01191
2015: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01129
Total number of active participants reported on line 7a of the Form 55002015-09-01182
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 participants2015-09-01182
Total participants2015-09-01182
2014: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01112
Total number of active participants reported on line 7a of the Form 55002014-09-01129
Total of all active and inactive participants2014-09-01129
Total participants2014-09-01129
2013: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01114
Total number of active participants reported on line 7a of the Form 55002013-09-01118
Number of retired or separated participants receiving benefits2013-09-011
Total of all active and inactive participants2013-09-01119
Total participants2013-09-01119
2012: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01100
Total number of active participants reported on line 7a of the Form 55002012-09-01114
Number of retired or separated participants receiving benefits2012-09-011
Total of all active and inactive participants2012-09-01115
Total participants2012-09-01115
2011: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01111
Total number of active participants reported on line 7a of the Form 55002011-09-01100
Total of all active and inactive participants2011-09-01100
Total participants2011-09-01100

Form 5500 Responses for HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN

2019: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)No
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
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
2016: HARNESS ROOFING, INC. EMPLOYEE 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: HARNESS ROOFING, INC. EMPLOYEE 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: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedYes
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedYes
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: HARNESS ROOFING, INC. EMPLOYEE WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01First time form 5500 has been submittedYes
2011-09-01Submission has been amendedYes
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 )
Policy contract number53761
Policy instance 6
Insurance contract or identification number53761
Number of Individuals Covered347
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $57,012
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,452,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,012
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5994892
Policy instance 5
Insurance contract or identification number5994892
Number of Individuals Covered335
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $10,855
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $75,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,855
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number155397
Policy instance 4
Insurance contract or identification number155397
Number of Individuals Covered116
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $4,430
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,430
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000003568
Policy instance 3
Insurance contract or identification number000003568
Number of Individuals Covered409
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $13,794
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,794
Insurance broker organization code?3
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number29793
Policy instance 2
Insurance contract or identification number29793
Number of Individuals Covered231
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $2,255
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,255
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number155397
Policy instance 1
Insurance contract or identification number155397
Number of Individuals Covered44
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $1,854
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,854
Insurance broker organization code?3
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number29793
Policy instance 1
Insurance contract or identification number29793
Number of Individuals Covered252
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $1,928
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,928
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number155397
Policy instance 5
Insurance contract or identification number155397
Number of Individuals Covered138
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $5,127
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,127
Insurance broker organization code?3
QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 )
Policy contract number53761
Policy instance 3
Insurance contract or identification number53761
Number of Individuals Covered366
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $43,747
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,198,239
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,747
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000003568
Policy instance 4
Insurance contract or identification number000003568
Number of Individuals Covered449
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $11,502
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,502
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5994892
Policy instance 2
Insurance contract or identification number5994892
Number of Individuals Covered346
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $9,399
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $58,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,399
Insurance broker organization code?3
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number29793
Policy instance 3
Insurance contract or identification number29793
Number of Individuals Covered344
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $2,066
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 )
Policy contract number53761
Policy instance 1
Insurance contract or identification number53761
Number of Individuals Covered298
Total amount of commissions paid to insurance brokerUSD $6,146
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,065,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05994892
Policy instance 5
Insurance contract or identification numberKM05994892
Number of Individuals Covered198
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $7,911
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $55,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number155397
Policy instance 2
Insurance contract or identification number155397
Number of Individuals Covered87
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $4,996
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000003568
Policy instance 4
Insurance contract or identification number000003568
Number of Individuals Covered362
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $11,306
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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