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STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN 401k Plan overview

Plan NameSTERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN
Plan identification number 502

STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

STERLING ATM, INC. has sponsored the creation of one or more 401k plans.

Company Name:STERLING ATM, INC.
Employer identification number (EIN):900045467
NAIC Classification:331310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-08-01DIANA MARTINEZ2023-11-27
5022021-08-01DIANA MARTINEZ2023-02-20

Plan Statistics for STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN

401k plan membership statisitcs for STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN

Measure Date Value
2022: STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-08-01111
Total number of active participants reported on line 7a of the Form 55002022-08-01101
Number of retired or separated participants receiving benefits2022-08-010
Number of other retired or separated participants entitled to future benefits2022-08-010
Total of all active and inactive participants2022-08-01101
Number of employers contributing to the scheme2022-08-010
2021: STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01104
Total number of active participants reported on line 7a of the Form 55002021-08-01111
Number of retired or separated participants receiving benefits2021-08-010
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-01111
Number of employers contributing to the scheme2021-08-010

Form 5500 Responses for STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN

2022: STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-08-01Type of plan entitySingle employer plan
2022-08-01Plan funding arrangement – InsuranceYes
2022-08-01Plan funding arrangement – General assets of the sponsorYes
2022-08-01Plan benefit arrangement – InsuranceYes
2022-08-01Plan benefit arrangement – General assets of the sponsorYes
2021: STERLING ATM INC. HEALTH AND WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01First time form 5500 has been submittedYes
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan funding arrangement – General assets of the sponsorYes
2021-08-01Plan benefit arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number38858
Policy instance 1
Insurance contract or identification number38858
Number of Individuals Covered97
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $6,817
Total amount of fees paid to insurance companyUSD $3,108
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $67,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,817
Amount paid for insurance broker fees3108
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberGRP00004046
Policy instance 1
Insurance contract or identification numberGRP00004046
Number of Individuals Covered117
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $3,255
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,906
Amount paid for insurance broker fees0
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number12008306
Policy instance 2
Insurance contract or identification number12008306
Number of Individuals Covered77
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $2,867
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $41,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,867
Amount paid for insurance broker fees0
Insurance broker organization code?3

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