ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH 401k Plan overview
| Plan Name | ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH |
| Plan identification number | 504 |
ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Health (other than dental or vision)
|
401k Sponsoring company profile
ADIMAB, LLC has sponsored the creation of one or more 401k plans.
Additional information about ADIMAB, LLC
| Jurisdiction of Incorporation: | State of Delaware Division of Corporations |
| Incorporation Date: | |
| Company Identification Number: | 4913986 |
More information about ADIMAB, LLC
Form 5500 Filing Information
Submission information for form 5500 for 401k plan ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 504 | 2022-10-01 | HANNAH PELLETIER | 2024-05-02 | | |
| 504 | 2021-10-01 | CAITLIN PIERCE | 2023-05-09 | | |
Plan Statistics for ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH
401k plan membership statisitcs for ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH
| Measure | Date | Value |
|---|
| 2022: ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-10-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-01 | 127 |
| Number of retired or separated participants receiving benefits | 2022-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-10-01 | 0 |
| Total of all active and inactive participants | 2022-10-01 | 127 |
| Number of employers contributing to the scheme | 2022-10-01 | 0 |
| 2021: ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 101 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 116 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 119 |
| Number of employers contributing to the scheme | 2021-10-01 | 0 |
Form 5500 Responses for ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH
| 2022: ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH 2022 form 5500 responses |
|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: ADIMAB, LLC EMPLOYEE BENEFITS PLAN HEALTH 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | First time form 5500 has been submitted | Yes |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| HARVARD PILGRIM HEALTH CARE OF NE, INC. (National Association of Insurance Commissioners NAIC id number: 96917 ) |
| Policy contract number | C60281 |
| Policy instance | 1 |
| Insurance contract or identification number | C60281 | | Number of Individuals Covered | 195 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $54,534 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,722,620 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,541 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
| Policy contract number | 272870000 |
| Policy instance | 1 |
| Insurance contract or identification number | 272870000 | | Number of Individuals Covered | 195 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $58,811 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,506,460 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $42,456 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
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