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ATA SERVICES, INC. HEALTH & WELFARE PLAN 401k Plan overview

Plan NameATA SERVICES, INC. HEALTH & WELFARE PLAN
Plan identification number 501

ATA SERVICES, INC. HEALTH & WELFARE 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)
  • 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.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

ATA SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:ATA SERVICES, INC.
Employer identification number (EIN):841250323
NAIC Classification:561300

Additional information about ATA SERVICES, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1993-11-22
Company Identification Number: 19931130623
Legal Registered Office Address: 405 Urban St Ste 150

Lakewood
United States of America (USA)
80228

More information about ATA SERVICES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ATA SERVICES, INC. HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-03-01KARI KNOWLES2022-08-22
5012020-03-01KARI KNOWLES2021-11-01
5012019-03-01KARI KNOWLES2020-10-19
5012019-01-01KARI KNOWLES2020-10-19
5012019-01-01KARI KNOWLES2019-12-09
5012018-01-01JENNIFER RIVA-KIRK2019-07-08 JENNIFER RIVA2019-07-08
5012018-01-01KARI E. KNOWLES2019-09-30
5012017-01-01JENNIFER RIVA-KIRK2018-07-13 JENNIFER RIVA-KIRK2018-07-13
5012017-01-01
5012016-01-01JENNIFER RIVA-KIRK2017-09-18 JENNIFER RIVA-KIRK2017-09-18
5012015-01-01DERRICK QUAN2016-10-17
5012014-03-01DERRICK QUAN2015-10-15

Plan Statistics for ATA SERVICES, INC. HEALTH & WELFARE PLAN

401k plan membership statisitcs for ATA SERVICES, INC. HEALTH & WELFARE PLAN

Measure Date Value
2021: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-03-01100
Total number of active participants reported on line 7a of the Form 55002021-03-0137
Number of retired or separated participants receiving benefits2021-03-010
Number of other retired or separated participants entitled to future benefits2021-03-010
Total of all active and inactive participants2021-03-0137
Number of employers contributing to the scheme2021-03-010
2020: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-03-01110
Total number of active participants reported on line 7a of the Form 55002020-03-0198
Number of retired or separated participants receiving benefits2020-03-011
Number of other retired or separated participants entitled to future benefits2020-03-010
Total of all active and inactive participants2020-03-0199
Number of employers contributing to the scheme2020-03-010
2019: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-03-0165
Total number of active participants reported on line 7a of the Form 55002019-03-0161
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-0161
Number of employers contributing to the scheme2019-03-010
Total participants, beginning-of-year2019-01-01142
Total number of active participants reported on line 7a of the Form 55002019-01-0165
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0165
Number of employers contributing to the scheme2019-01-010
2018: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01142
Total number of active participants reported on line 7a of the Form 55002018-01-01142
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01142
Number of employers contributing to the scheme2018-01-010
2017: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01123
Total number of active participants reported on line 7a of the Form 55002017-01-01142
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01142

Form 5500 Responses for ATA SERVICES, INC. HEALTH & WELFARE PLAN

2021: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: ATA SERVICES, INC. HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BBKY
Policy instance 2
Insurance contract or identification numberGLUG0BBKY
Number of Individuals Covered19
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $1,805
Total amount of fees paid to insurance companyUSD $4,272
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
Welfare Benefit Premiums Paid to CarrierUSD $13,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,805
Amount paid for insurance broker fees4272
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract numberL02479
Policy instance 1
Insurance contract or identification numberL02479
Number of Individuals Covered54
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $15,990
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $499,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,990
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914603
Policy instance 1
Insurance contract or identification number914603
Number of Individuals Covered220
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $42,974
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,074,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,974
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BBKV
Policy instance 2
Insurance contract or identification numberGLUG0BBKV
Number of Individuals Covered52
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $4,394
Total amount of fees paid to insurance companyUSD $883
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
Welfare Benefit Premiums Paid to CarrierUSD $32,088
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,394
Amount paid for insurance broker fees883
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914603
Policy instance 1
Insurance contract or identification number914603
Number of Individuals Covered103
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $43,586
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $615,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,586
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BBKV
Policy instance 2
Insurance contract or identification numberGLUG0BBKV
Number of Individuals Covered61
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $6,019
Total amount of fees paid to insurance companyUSD $1,235
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
Welfare Benefit Premiums Paid to CarrierUSD $43,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,019
Amount paid for insurance broker fees1235
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914603
Policy instance 1
Insurance contract or identification number914603
Number of Individuals Covered100
Insurance policy start date2018-07-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $26,302
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $657,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,302
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BBKV
Policy instance 2
Insurance contract or identification numberGLUG0BBKV
Number of Individuals Covered65
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $7,077
Total amount of fees paid to insurance companyUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $50,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,077
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10130187
Policy instance 1
Insurance contract or identification number10130187
Number of Individuals Covered142
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $1,254
Total amount of fees paid to insurance companyUSD $51
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $10,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,254
Amount paid for insurance broker fees51
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10130187
Policy instance 1
Insurance contract or identification number10130187
Number of Individuals Covered79
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $1,347
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $11,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,347
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC

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