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TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 401k Plan overview

Plan NameTRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN
Plan identification number 501

TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Vision

401k Sponsoring company profile

TRAVIS INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:TRAVIS INDUSTRIES, INC.
Employer identification number (EIN):911403129
NAIC Classification:332900

Additional information about TRAVIS INDUSTRIES, INC.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 1988-03-08
Company Identification Number: 601073429
Legal Registered Office Address: 1413 E HAWTHORNE RD

SPOKANE
United States of America (USA)
992183100

More information about TRAVIS INDUSTRIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-08-01SCOTT CHAFFIN2022-12-19
5012020-08-01SCOTT CHAFFIN2022-02-07 SCOTT CHAFFIN2022-02-07
5012019-08-01SCOTT CHAFFIN2021-05-12 SCOTT CHAFFIN2021-05-12
5012018-08-01SCOTT CHAFFIN2019-11-18 SCOTT CHAFFIN2019-11-18
5012017-08-01
5012016-08-01
5012015-08-01
5012014-08-01
5012013-08-01JIM CLAY
5012012-08-01MARY WRIGHT MARY WRIGHT2014-06-06
5012011-08-01MARY WRIGHT2013-06-14 MARY WRIGHT2014-05-30
5012010-08-01MARY WRIGHT
5012009-08-01TRAVIS GARSKE

Plan Statistics for TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN

401k plan membership statisitcs for TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2021: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01408
Total number of active participants reported on line 7a of the Form 55002021-08-010
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 participants2021-08-010
Number of employers contributing to the scheme2021-08-010
2020: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01344
Total number of active participants reported on line 7a of the Form 55002020-08-01376
Total of all active and inactive participants2020-08-01376
2019: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01359
Total number of active participants reported on line 7a of the Form 55002019-08-01344
Total of all active and inactive participants2019-08-01344
2018: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01364
Total number of active participants reported on line 7a of the Form 55002018-08-01359
Total of all active and inactive participants2018-08-01359
2017: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01338
Total number of active participants reported on line 7a of the Form 55002017-08-01364
Total of all active and inactive participants2017-08-01364
2016: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01319
Total number of active participants reported on line 7a of the Form 55002016-08-01338
Total of all active and inactive participants2016-08-01338
2015: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01310
Total number of active participants reported on line 7a of the Form 55002015-08-01319
Total of all active and inactive participants2015-08-01319
2014: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01294
Total number of active participants reported on line 7a of the Form 55002014-08-01310
Total of all active and inactive participants2014-08-01310
2013: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01270
Total number of active participants reported on line 7a of the Form 55002013-08-01294
Total of all active and inactive participants2013-08-01294
Total participants2013-08-01294
2012: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01271
Total number of active participants reported on line 7a of the Form 55002012-08-01270
Total of all active and inactive participants2012-08-01270
Total participants2012-08-01270
2011: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01280
Total number of active participants reported on line 7a of the Form 55002011-08-01271
Total of all active and inactive participants2011-08-01271
Total participants2011-08-01271
2010: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-08-01261
Total number of active participants reported on line 7a of the Form 55002010-08-01280
Total of all active and inactive participants2010-08-01280
Total participants2010-08-01280
2009: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01262
Total number of active participants reported on line 7a of the Form 55002009-08-01261
Total of all active and inactive participants2009-08-01261
Total participants2009-08-01261

Form 5500 Responses for TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN

2021: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01This submission is the final filingYes
2021-08-01Plan funding arrangement – General assets of the sponsorYes
2021-08-01Plan benefit arrangement – General assets of the sponsorYes
2020: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – General assets of the sponsorYes
2020-08-01Plan benefit arrangement – General assets of the sponsorYes
2019: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – General assets of the sponsorYes
2019-08-01Plan benefit arrangement – General assets of the sponsorYes
2018: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – General assets of the sponsorYes
2018-08-01Plan benefit arrangement – General assets of the sponsorYes
2017: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – General assets of the sponsorYes
2017-08-01Plan benefit arrangement – General assets of the sponsorYes
2016: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Plan funding arrangement – General assets of the sponsorYes
2016-08-01Plan benefit arrangement – General assets of the sponsorYes
2015: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Plan funding arrangement – General assets of the sponsorYes
2015-08-01Plan benefit arrangement – General assets of the sponsorYes
2014: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Plan funding arrangement – General assets of the sponsorYes
2014-08-01Plan benefit arrangement – General assets of the sponsorYes
2013: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – InsuranceYes
2011: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Submission has been amendedNo
2011-08-01This submission is the final filingNo
2011-08-01This return/report is a short plan year return/report (less than 12 months)No
2011-08-01Plan is a collectively bargained planNo
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – InsuranceYes
2010: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Submission has been amendedNo
2010-08-01This submission is the final filingNo
2010-08-01This return/report is a short plan year return/report (less than 12 months)No
2010-08-01Plan is a collectively bargained planNo
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – InsuranceYes
2009: TRAVIS PATTERN & FOUNDRY INC EMPLOYEE HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

FIRST CHOICE HEALTH EAP (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberTF104
Policy instance 1
Insurance contract or identification numberTF104
Number of Individuals Covered294
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $30,285
Total amount of fees paid to insurance companyUSD $90,346
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,285
Insurance broker nameO'CONNELL PIERCE BENEFITS LLC
FIRST CHOICE HEALTH EAP (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberTF104
Policy instance 1
Insurance contract or identification numberTF104
Number of Individuals Covered270
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $29,358
Total amount of fees paid to insurance companyUSD $86,535
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,358
Insurance broker nameO'CONNELL PIERCE BENEFITS LLC
FIRST CHOICE HEALTH EAP (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberTF104
Policy instance 1
Insurance contract or identification numberTF104
Number of Individuals Covered271
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $30,213
Total amount of fees paid to insurance companyUSD $88,475
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL17848
Policy instance 1
Insurance contract or identification numberHCL17848
Number of Individuals Covered280
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $29,457
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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