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EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN 401k Plan overview

Plan NameEMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN
Plan identification number 501

EMPOWER RETIREMENT LLC EMP WELFARE BEN 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

EMPOWER RETIREMENT, LLC has sponsored the creation of one or more 401k plans.

Company Name:EMPOWER RETIREMENT, LLC
Employer identification number (EIN):841233483
NAIC Classification:524290

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01KELLEY A. FERGUSON2024-07-24
5012022-01-01KELLEY FERGUSON2023-07-21
5012021-01-01KELLEY FERGUSON2022-09-19
5012020-01-01KELLEY FERGUSON2021-07-14
5012020-01-01KELLEY FERGUSON2022-09-19

Plan Statistics for EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN

401k plan membership statisitcs for EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN

Measure Date Value
2023: EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-019,966
Total number of active participants reported on line 7a of the Form 55002023-01-019,986
Number of retired or separated participants receiving benefits2023-01-01117
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-0110,103
Number of employers contributing to the scheme2023-01-010
2022: EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-017,988
Total number of active participants reported on line 7a of the Form 55002022-01-019,848
Number of retired or separated participants receiving benefits2022-01-01118
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-019,966
Number of employers contributing to the scheme2022-01-010
2021: EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-015,430
Total number of active participants reported on line 7a of the Form 55002021-01-017,685
Number of retired or separated participants receiving benefits2021-01-0173
Number of other retired or separated participants entitled to future benefits2021-01-01230
Total of all active and inactive participants2021-01-017,988
Number of employers contributing to the scheme2021-01-010
2020: EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-015,447
Total number of active participants reported on line 7a of the Form 55002020-01-015,282
Number of retired or separated participants receiving benefits2020-01-0151
Number of other retired or separated participants entitled to future benefits2020-01-0197
Total of all active and inactive participants2020-01-015,430
Number of employers contributing to the scheme2020-01-010

Form 5500 Responses for EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN

2023: EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: EMPOWER RETIREMENT LLC EMP WELFARE BEN PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number21173
Policy instance 1
Insurance contract or identification number21173
Number of Individuals Covered9978
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $270,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL163268
Policy instance 2
Insurance contract or identification numberGL163268
Number of Individuals Covered11685
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $367,130
Total amount of fees paid to insurance companyUSD $389,122
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $7,782,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number21173
Policy instance 1
Insurance contract or identification number21173
Number of Individuals Covered9896
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $143,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL163269
Policy instance 2
Insurance contract or identification number235933
Number of Individuals Covered112
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $6,163
Total amount of fees paid to insurance companyUSD $3,150
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $243,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,163
Insurance broker organization code?3
Amount paid for insurance broker fees3150
Additional information about fees paid to insurance brokerBONUS
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT,CRITICAL ILLNESS
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number21173
Policy instance 1
Insurance contract or identification number21173
Number of Individuals Covered7647
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $140,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960368
Policy instance 2
Insurance contract or identification numberFLK960368
Number of Individuals Covered7685
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $63,934
Total amount of fees paid to insurance companyUSD $106,555
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,137,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $63,930
Amount paid for insurance broker fees106549
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL163269
Policy instance 3
Insurance contract or identification numberGL163269
Number of Individuals Covered7560
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $79,254
Total amount of fees paid to insurance companyUSD $124,669
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $2,493,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $79,254
Amount paid for insurance broker fees124669
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number21173
Policy instance 1
Insurance contract or identification number21173
Number of Individuals Covered5250
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $96,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960368
Policy instance 2
Insurance contract or identification numberFLK960368
Number of Individuals Covered5282
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $122,014
Total amount of fees paid to insurance companyUSD $251,584
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,071,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $122,014
Amount paid for insurance broker fees251584
Additional information about fees paid to insurance brokerSALES AND SERVICE OVERRIDE
Insurance broker organization code?3

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