401k Plan data: DIRECT WATER WELFARE BENEFIT PLAN plan

DIRECT WATER WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	DIRECT WATER WELFARE BENEFIT PLAN
Plan identification number	501

DIRECT WATER WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Other welfare benefit cover 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

DIRECT WATER has sponsored the creation of one or more 401k plans.

Company Name: DIRECT WATER

Employer identification number (EIN): 823292423

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DIRECT WATER WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-11-01

Plan Statistics for DIRECT WATER WELFARE BENEFIT PLAN

401k plan membership statisitcs for DIRECT WATER WELFARE BENEFIT PLAN

Measure Date Value
2023: DIRECT WATER WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-11-01 122
Total number of active participants reported on line 7a of the Form 5500 2023-11-01 95
Number of retired or separated participants receiving benefits 2023-11-01 0
Number of other retired or separated participants entitled to future benefits 2023-11-01 0
Total of all active and inactive participants 2023-11-01 95

Measure	Date	Value
2023: DIRECT WATER WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-11-01	122
Total number of active participants reported on line 7a of the Form 5500	2023-11-01	95
Number of retired or separated participants receiving benefits	2023-11-01	0
Number of other retired or separated participants entitled to future benefits	2023-11-01	0
Total of all active and inactive participants	2023-11-01	95

Form 5500 Responses for DIRECT WATER WELFARE BENEFIT PLAN

2023: DIRECT WATER WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-11-01	Type of plan entity	Single employer plan
2023-11-01	First time form 5500 has been submitted	Yes
2023-11-01	Submission has been amended	No
2023-11-01	This submission is the final filing	No
2023-11-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2023-11-01	Plan is a collectively bargained plan	No
2023-11-01	Plan funding arrangement – Insurance	Yes
2023-11-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-11-01	Plan benefit arrangement – Insurance	Yes
2023-11-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

MEC

Policy instance

Insurance contract or identification number	MEC
Number of Individuals Covered	161
Insurance policy start date	2023-11-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $1,412
Total amount of fees paid to insurance company	USD $2,010
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	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
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 $19,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

THE NORTH RIVER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 44520 )

Policy contract number

ACCIDENT

Policy instance

Insurance contract or identification number	ACCIDENT
Number of Individuals Covered	161
Insurance policy start date	2023-11-01
Insurance policy end date	2023-12-31
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENT
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 $495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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Company Name:	DIRECT WATER
Employer identification number (EIN):	823292423