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USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN 401k Plan overview

Plan NameUSW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN
Plan identification number 501

USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Collectively bargained welfare benefit arrangement under Code section 419A(f)(5).

401k Sponsoring company profile

USW-UAW KELSEY-HAYES RETIREES has sponsored the creation of one or more 401k plans.

Company Name:USW-UAW KELSEY-HAYES RETIREES
Employer identification number (EIN):861748324
NAIC Classification:813930
NAIC Description:Labor Unions and Similar Labor Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01S. HOWARD KLINE2024-10-11
5012022-01-01S. HOWARD KLINE2023-10-16
5012021-04-01S. HOWARD KLINE2022-10-17

Financial Data on USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN

Measure Date Value
2023 : USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN 2023 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2023-12-31$423,664
Total unrealized appreciation/depreciation of assets2023-12-31$423,664
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$16,484
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$15,001
Total income from all sources (including contributions)2023-12-31$1,783,477
Total loss/gain on sale of assets2023-12-31$-103,538
Total of all expenses incurred2023-12-31$1,122,770
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$973,552
Value of total assets at end of year2023-12-31$24,943,389
Value of total assets at beginning of year2023-12-31$24,281,199
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$149,218
Total interest from all sources2023-12-31$611,815
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$287,883
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2023-12-31$244,142
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2023-12-31$138,867
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-12-31$20,518
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-12-31$13,456
Administrative expenses (other) incurred2023-12-31$29,946
Liabilities. Value of operating payables at end of year2023-12-31$16,484
Liabilities. Value of operating payables at beginning of year2023-12-31$15,001
Total non interest bearing cash at end of year2023-12-31$42,260
Total non interest bearing cash at beginning of year2023-12-31$48,091
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$660,707
Value of net assets at end of year (total assets less liabilities)2023-12-31$24,926,905
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$24,266,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Investment advisory and management fees2023-12-31$36,362
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-12-31$5,614,618
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-12-31$4,267,498
Interest earned on other investments2023-12-31$596,237
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$270,698
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$71,747
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$71,747
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-12-31$15,578
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$834,685
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-12-31$563,653
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Employer contributions (assets) at end of year2023-12-31$15,232,693
Employer contributions (assets) at beginning of year2023-12-31$17,086,456
Income. Dividends from common stock2023-12-31$43,741
Contract administrator fees2023-12-31$31,488
Assets. Corporate common stocks other than exployer securities at end of year2023-12-31$3,762,602
Assets. Corporate common stocks other than exployer securities at beginning of year2023-12-31$2,793,951
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Aggregate proceeds on sale of assets2023-12-31$1,979,414
Aggregate carrying amount (costs) on sale of assets2023-12-31$2,082,952
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31GROSSMAN YANAK & FORD LLP
Accountancy firm EIN2023-12-31251638525
Unrealized appreciation/depreciation of other (non real estate) assets2023-01-01$423,664
Total unrealized appreciation/depreciation of assets2023-01-01$423,664
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$16,484
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$15,001
Total income from all sources (including contributions)2023-01-01$1,783,477
Total loss/gain on sale of assets2023-01-01$-103,538
Total of all expenses incurred2023-01-01$1,122,770
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-01$973,552
Value of total assets at end of year2023-01-01$24,943,389
Value of total assets at beginning of year2023-01-01$24,281,199
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-01$149,218
Total interest from all sources2023-01-01$611,815
Total dividends received (eg from common stock, registered investment company shares)2023-01-01$287,883
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-01No
Total dividends received from registered investment company shares (eg mutual funds)2023-01-01$244,142
Was this plan covered by a fidelity bond2023-01-01Yes
Value of fidelity bond cover2023-01-01$500,000
Were there any nonexempt tranactions with any party-in-interest2023-01-01No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2023-01-01$138,867
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-01-01$20,518
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-01-01$13,456
Administrative expenses (other) incurred2023-01-01$29,946
Liabilities. Value of operating payables at end of year2023-01-01$16,484
Liabilities. Value of operating payables at beginning of year2023-01-01$15,001
Total non interest bearing cash at end of year2023-01-01$42,260
Total non interest bearing cash at beginning of year2023-01-01$48,091
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Value of net income/loss2023-01-01$660,707
Value of net assets at end of year (total assets less liabilities)2023-01-01$24,926,905
Value of net assets at beginning of year (total assets less liabilities)2023-01-01$24,266,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-01No
Were any leases to which the plan was party in default or uncollectible2023-01-01No
Investment advisory and management fees2023-01-01$36,362
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-01-01$5,614,618
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-01-01$4,267,498
Interest earned on other investments2023-01-01$596,237
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-01-01$270,698
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-01-01$15,578
Expenses. Payments to insurance carriers foe the provision of benefits2023-01-01$834,685
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-01-01$563,653
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-01No
Was there a failure to transmit to the plan any participant contributions2023-01-01No
Has the plan failed to provide any benefit when due under the plan2023-01-01No
Employer contributions (assets) at end of year2023-01-01$15,232,693
Employer contributions (assets) at beginning of year2023-01-01$17,086,456
Income. Dividends from common stock2023-01-01$43,741
Contract administrator fees2023-01-01$31,488
Assets. Corporate common stocks other than exployer securities at end of year2023-01-01$3,762,602
Assets. Corporate common stocks other than exployer securities at beginning of year2023-01-01$2,793,951
Did the plan have assets held for investment2023-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-01No
Aggregate proceeds on sale of assets2023-01-01$1,979,414
Aggregate carrying amount (costs) on sale of assets2023-01-01$2,082,952
Opinion of an independent qualified public accountant for this plan2023-01-011
Accountancy firm name2023-01-01GROSSMAN YANAK & FORD LLP
Accountancy firm EIN2023-01-01251638525
2022 : USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-356,028
Total unrealized appreciation/depreciation of assets2022-12-31$-356,028
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$15,001
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$12,061
Total income from all sources (including contributions)2022-12-31$-574,381
Total loss/gain on sale of assets2022-12-31$-27,820
Total of all expenses incurred2022-12-31$1,342,505
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,199,848
Value of total assets at end of year2022-12-31$24,281,199
Value of total assets at beginning of year2022-12-31$26,195,145
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$142,657
Total interest from all sources2022-12-31$660,301
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$214,687
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$181,332
Administrative expenses professional fees incurred2022-12-31$46,942
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$187,250
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$13,456
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$8,954
Administrative expenses (other) incurred2022-12-31$68,320
Liabilities. Value of operating payables at end of year2022-12-31$15,001
Liabilities. Value of operating payables at beginning of year2022-12-31$12,061
Total non interest bearing cash at end of year2022-12-31$48,091
Total non interest bearing cash at beginning of year2022-12-31$175,630
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,916,886
Value of net assets at end of year (total assets less liabilities)2022-12-31$24,266,198
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$26,183,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$27,395
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$4,267,498
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$4,181,846
Interest earned on other investments2022-12-31$657,437
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$71,747
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$670,937
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$670,937
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$2,864
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$1,012,598
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,065,521
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Employer contributions (assets) at end of year2022-12-31$17,086,456
Employer contributions (assets) at beginning of year2022-12-31$18,879,019
Income. Dividends from common stock2022-12-31$33,355
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$2,793,951
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$2,278,759
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$3,616,633
Aggregate carrying amount (costs) on sale of assets2022-12-31$3,644,453
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31GROSSMAN YANAK & FORD LLP
Accountancy firm EIN2022-12-31251638525
Unrealized appreciation/depreciation of other (non real estate) assets2022-01-01$-356,028
Total unrealized appreciation/depreciation of assets2022-01-01$-356,028
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$15,001
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$12,061
Total income from all sources (including contributions)2022-01-01$-574,381
Total loss/gain on sale of assets2022-01-01$-27,820
Total of all expenses incurred2022-01-01$1,342,505
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$1,199,848
Value of total assets at end of year2022-01-01$24,281,199
Value of total assets at beginning of year2022-01-01$26,195,145
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$142,657
Total interest from all sources2022-01-01$660,301
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$214,687
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-01No
Total dividends received from registered investment company shares (eg mutual funds)2022-01-01$181,332
Administrative expenses professional fees incurred2022-01-01$46,942
Was this plan covered by a fidelity bond2022-01-01Yes
Value of fidelity bond cover2022-01-01$500,000
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-01-01$187,250
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-01-01$13,456
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-01-01$8,954
Administrative expenses (other) incurred2022-01-01$68,320
Liabilities. Value of operating payables at end of year2022-01-01$15,001
Liabilities. Value of operating payables at beginning of year2022-01-01$12,061
Total non interest bearing cash at end of year2022-01-01$48,091
Total non interest bearing cash at beginning of year2022-01-01$175,630
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Value of net income/loss2022-01-01$-1,916,886
Value of net assets at end of year (total assets less liabilities)2022-01-01$24,266,198
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$26,183,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Investment advisory and management fees2022-01-01$27,395
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-01-01$4,267,498
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-01-01$4,181,846
Interest earned on other investments2022-01-01$657,437
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-01-01$71,747
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-01-01$2,864
Expenses. Payments to insurance carriers foe the provision of benefits2022-01-01$1,012,598
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-01-01$-1,065,521
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01No
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Employer contributions (assets) at end of year2022-01-01$17,086,456
Employer contributions (assets) at beginning of year2022-01-01$18,879,019
Income. Dividends from common stock2022-01-01$33,355
Assets. Corporate common stocks other than exployer securities at end of year2022-01-01$2,793,951
Assets. Corporate common stocks other than exployer securities at beginning of year2022-01-01$2,278,759
Did the plan have assets held for investment2022-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01No
Aggregate proceeds on sale of assets2022-01-01$3,616,633
Aggregate carrying amount (costs) on sale of assets2022-01-01$3,644,453
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01GROSSMAN YANAK & FORD LLP
Accountancy firm EIN2022-01-01251638525
2021 : USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$187,113
Total unrealized appreciation/depreciation of assets2021-12-31$187,113
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$12,061
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$27,205,167
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,022,083
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$928,549
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$27,014,264
Value of total assets at end of year2021-12-31$26,195,145
Value of total assets at beginning of year2021-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$93,534
Total interest from all sources2021-12-31$971
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$148,974
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$140,152
Administrative expenses professional fees incurred2021-12-31$24,775
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$8,954
Administrative expenses (other) incurred2021-12-31$54,957
Liabilities. Value of operating payables at end of year2021-12-31$12,061
Liabilities. Value of operating payables at beginning of year2021-12-31$0
Total non interest bearing cash at end of year2021-12-31$175,630
Total non interest bearing cash at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$26,183,084
Value of net assets at end of year (total assets less liabilities)2021-12-31$26,183,084
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$13,802
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$4,181,846
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$670,937
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$971
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$928,549
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$-146,155
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$27,014,264
Employer contributions (assets) at end of year2021-12-31$18,879,019
Employer contributions (assets) at beginning of year2021-12-31$0
Income. Dividends from common stock2021-12-31$8,822
Assets. Corporate common stocks other than exployer securities at end of year2021-12-31$2,278,759
Assets. Corporate common stocks other than exployer securities at beginning of year2021-12-31$0
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$375,000
Aggregate carrying amount (costs) on sale of assets2021-12-31$375,000
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31GROSSMAN YANAK & FORD LLP
Accountancy firm EIN2021-12-31251638525

Form 5500 Responses for USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN

2023: USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan is a collectively bargained planYes
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: USW-UAW KELSEY HAYES RETIREES HEALTH CARE PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01First time form 5500 has been submittedYes
2021-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-04-01Plan is a collectively bargained planYes
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – TrustYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number321751
Policy instance 1
Insurance contract or identification number321751
Number of Individuals Covered79
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
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $240,368
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 number321753
Policy instance 2
Insurance contract or identification number321753
Number of Individuals Covered196
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
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $594,317
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 number321751
Policy instance 1
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number321753
Policy instance 2
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number321751
Policy instance 1
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number321753
Policy instance 2

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