401k Plan data: AMERICAN POLLUTION CONTROL CORP. GROUP LIFE plan

AMERICAN POLLUTION CONTROL CORP. GROUP LIFE 401k Plan overview

Plan Name	AMERICAN POLLUTION CONTROL CORP. GROUP LIFE
Plan identification number	505

AMERICAN POLLUTION CONTROL CORP. GROUP LIFE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

AMERICAN POLLUTION CONTROL CORP has sponsored the creation of one or more 401k plans.

Company Name: AMERICAN POLLUTION CONTROL CORP

Employer identification number (EIN): 721263183

NAIC Classification: 541600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN POLLUTION CONTROL CORP. GROUP LIFE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2023-01-01 EVERETTE BABIN 2024-09-10
505 2022-01-01 EVERETTE BABIN 2023-10-13 EVERETTE BABIN 2023-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
505	2023-01-01	EVERETTE BABIN	2024-09-10
505	2022-01-01	EVERETTE BABIN	2023-10-13	EVERETTE BABIN	2023-10-13

Plan Statistics for AMERICAN POLLUTION CONTROL CORP. GROUP LIFE

401k plan membership statisitcs for AMERICAN POLLUTION CONTROL CORP. GROUP LIFE

Measure Date Value
2023: AMERICAN POLLUTION CONTROL CORP. GROUP LIFE 2023 401k membership
Total participants, beginning-of-year 2023-01-01 204
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 64
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 64
Number of employers contributing to the scheme 2023-01-01 0
2022: AMERICAN POLLUTION CONTROL CORP. GROUP LIFE 2022 401k membership
Total participants, beginning-of-year 2022-01-01 204
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 204
Total of all active and inactive participants 2022-01-01 204
Total participants 2022-01-01 204

Measure	Date	Value
2023: AMERICAN POLLUTION CONTROL CORP. GROUP LIFE 2023 401k membership
Total participants, beginning-of-year	2023-01-01	204
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	64
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	64
Number of employers contributing to the scheme	2023-01-01	0
2022: AMERICAN POLLUTION CONTROL CORP. GROUP LIFE 2022 401k membership
Total participants, beginning-of-year	2022-01-01	204
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	204
Total of all active and inactive participants	2022-01-01	204
Total participants	2022-01-01	204

Form 5500 Responses for AMERICAN POLLUTION CONTROL CORP. GROUP LIFE

2023: AMERICAN POLLUTION CONTROL CORP. GROUP LIFE 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: AMERICAN POLLUTION CONTROL CORP. GROUP LIFE 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	First time form 5500 has been submitted	Yes
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

743898

Policy instance

Insurance contract or identification number	743898
Number of Individuals Covered	64
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $2,883
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $15,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

743898

Policy instance

Insurance contract or identification number	743898
Number of Individuals Covered	204
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,176
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $14,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,176
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	0
Insurance broker organization code?	3

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Company Name:	AMERICAN POLLUTION CONTROL CORP
Employer identification number (EIN):	721263183
NAIC Classification:	541600