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MIDWEST FLOOR COVERINGS, INC. 401k Plan overview

Plan NameMIDWEST FLOOR COVERINGS, INC.
Plan identification number 501

MIDWEST FLOOR COVERINGS, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

MIDWEST FLOOR COVERINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name:MIDWEST FLOOR COVERINGS, INC.
Employer identification number (EIN):870153288
NAIC Classification:423300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIDWEST FLOOR COVERINGS, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01
5012021-07-01
5012020-07-01
5012019-07-01
5012018-07-01
5012017-07-01
5012016-07-01ADAM JENSEN2019-03-12
5012014-08-01ADAM JENSEN ADAM JENSEN2015-02-12

Plan Statistics for MIDWEST FLOOR COVERINGS, INC.

401k plan membership statisitcs for MIDWEST FLOOR COVERINGS, INC.

Measure Date Value
2022: MIDWEST FLOOR COVERINGS, INC. 2022 401k membership
Total participants, beginning-of-year2022-07-01211
Total number of active participants reported on line 7a of the Form 55002022-07-01174
Total of all active and inactive participants2022-07-01174
Total participants2022-07-01174
2021: MIDWEST FLOOR COVERINGS, INC. 2021 401k membership
Total participants, beginning-of-year2021-07-01204
Total number of active participants reported on line 7a of the Form 55002021-07-01200
Total of all active and inactive participants2021-07-01200
Total participants2021-07-01200
2020: MIDWEST FLOOR COVERINGS, INC. 2020 401k membership
Total participants, beginning-of-year2020-07-01181
Total number of active participants reported on line 7a of the Form 55002020-07-01195
Total of all active and inactive participants2020-07-01195
Total participants2020-07-01195
2019: MIDWEST FLOOR COVERINGS, INC. 2019 401k membership
Total participants, beginning-of-year2019-07-01210
Total number of active participants reported on line 7a of the Form 55002019-07-01182
Total of all active and inactive participants2019-07-01182
Total participants2019-07-01182
2018: MIDWEST FLOOR COVERINGS, INC. 2018 401k membership
Total participants, beginning-of-year2018-07-01222
Total number of active participants reported on line 7a of the Form 55002018-07-01208
Total of all active and inactive participants2018-07-01208
Total participants2018-07-01208
2017: MIDWEST FLOOR COVERINGS, INC. 2017 401k membership
Total participants, beginning-of-year2017-07-01117
Total number of active participants reported on line 7a of the Form 55002017-07-01116
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01116
2016: MIDWEST FLOOR COVERINGS, INC. 2016 401k membership
Total participants, beginning-of-year2016-07-01119
Total number of active participants reported on line 7a of the Form 55002016-07-01108
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01108
2014: MIDWEST FLOOR COVERINGS, INC. 2014 401k membership
Total participants, beginning-of-year2014-08-0190
Total number of active participants reported on line 7a of the Form 55002014-08-01130
Number of retired or separated participants receiving benefits2014-08-010
Number of other retired or separated participants entitled to future benefits2014-08-010
Total of all active and inactive participants2014-08-01130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-08-010
Total participants2014-08-01130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-08-010

Form 5500 Responses for MIDWEST FLOOR COVERINGS, INC.

2022: MIDWEST FLOOR COVERINGS, INC. 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: MIDWEST FLOOR COVERINGS, INC. 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: MIDWEST FLOOR COVERINGS, INC. 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: MIDWEST FLOOR COVERINGS, INC. 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: MIDWEST FLOOR COVERINGS, INC. 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: MIDWEST FLOOR COVERINGS, INC. 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: MIDWEST FLOOR COVERINGS, INC. 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: MIDWEST FLOOR COVERINGS, INC. 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01First time form 5500 has been submittedYes
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – General assets of the sponsorYes
2014-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number009923
Policy instance 1
Insurance contract or identification number009923
Number of Individuals Covered123
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $7,065
Total amount of fees paid to insurance companyUSD $2,355
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,065
Insurance broker organization code?3
Amount paid for insurance broker fees2355
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00278UT-05
Policy instance 3
Insurance contract or identification numberGB00278UT-05
Number of Individuals Covered68
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $9,003
Welfare Benefit Premiums Paid to CarrierUSD $300,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,003
Insurance broker organization code?3
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract numberMFL
Policy instance 2
Insurance contract or identification numberMFL
Number of Individuals Covered192
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $1,159
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,159
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberSLM540463
Policy instance 3
Insurance contract or identification numberSLM540463
Number of Individuals Covered86
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $46,083
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,083
Insurance broker organization code?3
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract numberMFL
Policy instance 2
Insurance contract or identification numberMFL
Number of Individuals Covered65
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $1,411
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,411
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number009923
Policy instance 1
Insurance contract or identification number009923
Number of Individuals Covered141
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $7,957
Total amount of fees paid to insurance companyUSD $4,520
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,957
Amount paid for insurance broker fees4520
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BB29
Policy instance 1
Insurance contract or identification numberG000BB29
Number of Individuals Covered114
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $1,999
Total amount of fees paid to insurance companyUSD $493
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,999
Amount paid for insurance broker fees493
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BB29
Policy instance 2
Insurance contract or identification numberG000BB29
Number of Individuals Covered66
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $1,848
Total amount of fees paid to insurance companyUSD $509
Other welfare benefits providedSHORT TERM DISABILITY VOLUNTARY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,848
Amount paid for insurance broker fees509
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract numberMFL
Policy instance 3
Insurance contract or identification numberMFL
Number of Individuals Covered62
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $977
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $977
Insurance broker organization code?3
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00278UT-04
Policy instance 4
Insurance contract or identification numberGB00278UT-04
Number of Individuals Covered85
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $35,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,864
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BB29
Policy instance 5
Insurance contract or identification numberG000BB29
Number of Individuals Covered113
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $966
Total amount of fees paid to insurance companyUSD $483
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $966
Amount paid for insurance broker fees483
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BB29
Policy instance 1
Insurance contract or identification numberG000BB29
Number of Individuals Covered108
Total amount of commissions paid to insurance brokerUSD $2,203
Total amount of fees paid to insurance companyUSD $1,308
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,203
Amount paid for insurance broker fees1308
Additional information about fees paid to insurance brokerOTHER COMPENSATION
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BB29
Policy instance 2
Insurance contract or identification numberG000BB29
Number of Individuals Covered67
Total amount of commissions paid to insurance brokerUSD $1,994
Total amount of fees paid to insurance companyUSD $1,175
Other welfare benefits providedSHORT TERM DISABILITY VOLUNTARY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,994
Amount paid for insurance broker fees1175
Additional information about fees paid to insurance brokerOTHER COMPENSATION
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract number
Policy instance 3
Number of Individuals Covered53
Total amount of commissions paid to insurance brokerUSD $1,124
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,124
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BB29
Policy instance 5
Insurance contract or identification numberG000BB29
Number of Individuals Covered106
Total amount of commissions paid to insurance brokerUSD $1,114
Total amount of fees paid to insurance companyUSD $618
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,114
Amount paid for insurance broker fees618
Additional information about fees paid to insurance brokerOTHER COMPENSATION
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00278UT-04
Policy instance 4
Insurance contract or identification numberGB00278UT-04
Number of Individuals Covered87
Total amount of commissions paid to insurance brokerUSD $41,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,146
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberLM0365942
Policy instance 1
Insurance contract or identification numberLM0365942
Number of Individuals Covered152
Total amount of commissions paid to insurance brokerUSD $1,936
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,936
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00278UT-03
Policy instance 5
Insurance contract or identification numberGB00278UT-03
Number of Individuals Covered116
Total amount of commissions paid to insurance brokerUSD $46,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,556
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract number
Policy instance 4
Number of Individuals Covered89
Total amount of commissions paid to insurance brokerUSD $1,072
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,072
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BB29
Policy instance 3
Insurance contract or identification numberG000BB29
Number of Individuals Covered73
Total amount of commissions paid to insurance brokerUSD $1,941
Total amount of fees paid to insurance companyUSD $1,386
Other welfare benefits providedSHORT TERM DISABILITY VOLUNTARY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,941
Amount paid for insurance broker fees1386
Additional information about fees paid to insurance brokerOTHER COMPENSATION
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000BB29
Policy instance 2
Insurance contract or identification numberG000BB29
Number of Individuals Covered134
Total amount of commissions paid to insurance brokerUSD $2,062
Total amount of fees paid to insurance companyUSD $1,537
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,062
Amount paid for insurance broker fees1537
Additional information about fees paid to insurance brokerOTHER COMPENSATION
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberLM0365942
Policy instance 2
Insurance contract or identification numberLM0365942
Number of Individuals Covered151
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $2,156
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )
Policy contract number
Policy instance 1
Number of Individuals Covered84
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,253
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberGB00278UT-02
Policy instance 3
Insurance contract or identification numberGB00278UT-02
Number of Individuals Covered116
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $44,075
Welfare Benefit Premiums Paid to CarrierUSD $291,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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