HEMASOURCE HEALTH AND WELFARE PLAN 401k Plan overview
| Plan Name | HEMASOURCE HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
HEMASOURCE HEALTH AND WELFARE PLAN Benefits
| 401k Plan Type | Welfare 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)
|
401k Sponsoring company profile
HEMASOURCE, INC. has sponsored the creation of one or more 401k plans.
| Company Name: | HEMASOURCE, INC. |
| Employer identification number (EIN): | 870574076 |
| NAIC Classification: | 424990 |
| NAIC Description: | Other Miscellaneous Nondurable Goods Merchant Wholesalers |
Additional information about HEMASOURCE, INC.
| Jurisdiction of Incorporation: | Colorado Department of State |
| Incorporation Date: | 1999-10-19 |
| Company Identification Number: | 19991195589 |
| Legal Registered Office Address: |
6 Crystal Park Dr.
Redstone
United States of America (USA)
81623
|
More information about HEMASOURCE, INC.
Form 5500 Filing Information
Submission information for form 5500 for 401k plan HEMASOURCE HEALTH AND WELFARE PLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 501 | 2023-01-01 | MATT ADAMS | 2024-07-02 | | |
Plan Statistics for HEMASOURCE HEALTH AND WELFARE PLAN
401k plan membership statisitcs for HEMASOURCE HEALTH AND WELFARE PLAN
| Measure | Date | Value |
|---|
| 2023: HEMASOURCE HEALTH AND WELFARE PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 128 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 128 |
| Number of employers contributing to the scheme | 2023-01-01 | 0 |
Form 5500 Responses for HEMASOURCE HEALTH AND WELFARE PLAN
| 2023: HEMASOURCE HEALTH AND WELFARE PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | First time form 5500 has been submitted | Yes |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| REGENCE BLUECROSS BLUESHIELD OF UTAH (National Association of Insurance Commissioners NAIC id number: 54550 ) |
| Policy contract number | 60024908 |
| Policy instance | 1 |
| Insurance contract or identification number | 60024908 | | Number of Individuals Covered | 245 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $72,038 | | Total amount of fees paid to insurance company | USD $3,030 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,445,641 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) |
| Policy contract number | GRP00004221 |
| Policy instance | 2 |
| Insurance contract or identification number | GRP00004221 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $693 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,849 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GUDS0BRKL |
| Policy instance | 3 |
| Insurance contract or identification number | GUDS0BRKL | | Number of Individuals Covered | 128 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $13,322 | | Total amount of fees paid to insurance company | USD $6,625 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $163,164 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
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