401k Plan data: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN plan

TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 401k Plan overview

Plan Name	TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN
Plan identification number	502

TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

TOOL GAUGE & MACHINE WORKS, INC. has sponsored the creation of one or more 401k plans.

Company Name: TOOL GAUGE & MACHINE WORKS, INC.

Employer identification number (EIN): 910817261

NAIC Classification: 326100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2018-07-01 JACQUELYN B. HOFLICH 2020-02-20
502 2018-07-01 JACQUELYN B. HOFLICH 2020-02-21
502 2017-07-01
502 2016-07-01
502 2015-07-01 GEORGIANA MARZANO

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
502	2018-07-01	JACQUELYN B. HOFLICH	2020-02-20
502	2018-07-01	JACQUELYN B. HOFLICH	2020-02-21
502	2017-07-01
502	2016-07-01
502	2015-07-01	GEORGIANA MARZANO

Plan Statistics for TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN

401k plan membership statisitcs for TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN

Measure Date Value
2018: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 106
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 145
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 0
Total of all active and inactive participants 2018-07-01 145
Number of employers contributing to the scheme 2018-07-01 0
2017: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 110
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 106
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 0
Total of all active and inactive participants 2017-07-01 106
2016: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 114
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 110
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 110
2015: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 105
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 114
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 114

Measure	Date	Value
2018: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	106
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	145
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	0
Total of all active and inactive participants	2018-07-01	145
Number of employers contributing to the scheme	2018-07-01	0
2017: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	110
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	106
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	0
Total of all active and inactive participants	2017-07-01	106
2016: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	114
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	110
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	110
2015: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	105
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	114
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	114

Form 5500 Responses for TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN

2018: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	Submission has been amended	Yes
2018-07-01	This submission is the final filing	Yes
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2017: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2016: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: TOOL GAUGE & MACHINE WORKS, INC. DENTAL/LIFE PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	First time form 5500 has been submitted	Yes
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5369323

Policy instance

Insurance contract or identification number	5369323
Number of Individuals Covered	89
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $2,109
Total amount of fees paid to insurance company	USD $3,064
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $46,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	2280
Additional information about fees paid to insurance broker	ADMINISTRATION FEES
Insurance broker organization code?	5

WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )

Policy contract number

WAG5

Policy instance

Insurance contract or identification number	WAG5
Number of Individuals Covered	20
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $609
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $609
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

COMPSYCH (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

EAP

Policy instance

Insurance contract or identification number	EAP
Number of Individuals Covered	145
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $1,309
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

GLUG0BCM8

Policy instance

Insurance contract or identification number	GLUG0BCM8
Number of Individuals Covered	145
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $5,913
Total amount of fees paid to insurance company	USD $4,240
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $41,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,913
Amount paid for insurance broker fees	1872
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3

LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )

Policy contract number

WBT000987

Policy instance

Insurance contract or identification number	WBT000987
Number of Individuals Covered	106
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $2,785
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $18,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,785
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICES, INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05945443

Policy instance

Insurance contract or identification number	KM05945443
Number of Individuals Covered	162
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $2,295
Total amount of fees paid to insurance company	USD $1,216
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $62,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,295
Amount paid for insurance broker fees	64
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICES, INC.

LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )

Policy contract number

WBT000987

Policy instance

Insurance contract or identification number	WBT000987
Number of Individuals Covered	114
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $5,048
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT EMPLOYEE ASSISTANCE PROGRAM
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $83,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,048
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICES, INC.

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Company Name:	TOOL GAUGE & MACHINE WORKS, INC.
Employer identification number (EIN):	910817261
NAIC Classification:	326100