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AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameAXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN
Plan identification number 501

AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

AXIOM CUSTOM PRODUCTS, INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name:AXIOM CUSTOM PRODUCTS, INCORPORATED
Employer identification number (EIN):931309219
NAIC Classification:238900

Additional information about AXIOM CUSTOM PRODUCTS, INCORPORATED

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 2001-01-08
Company Identification Number: 79004280
Legal Registered Office Address: 2424 NE RIVERSIDE WAY

PORTLAND
United States of America (USA)
97211

More information about AXIOM CUSTOM PRODUCTS, INCORPORATED

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-11-01CLARICE GAUF2019-04-23
5012016-11-01

Plan Statistics for AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN

401k plan membership statisitcs for AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN

Measure Date Value
2017: AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-11-01100
Total number of active participants reported on line 7a of the Form 55002017-11-01100
Number of retired or separated participants receiving benefits2017-11-010
Number of other retired or separated participants entitled to future benefits2017-11-010
Total of all active and inactive participants2017-11-01100
Number of employers contributing to the scheme2017-11-010
2016: AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-01100
Total number of active participants reported on line 7a of the Form 55002016-11-0177
Number of retired or separated participants receiving benefits2016-11-010
Number of other retired or separated participants entitled to future benefits2016-11-010
Total of all active and inactive participants2016-11-0177

Form 5500 Responses for AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN

2017: AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – InsuranceYes
2016: AXIOM CUSTOM PRODUCTS HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01First time form 5500 has been submittedYes
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingNo
2016-11-01This return/report is a short plan year return/report (less than 12 months)No
2016-11-01Plan is a collectively bargained planNo
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number693818
Policy instance 1
Insurance contract or identification number693818
Number of Individuals Covered144
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $18,900
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $564,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number520195
Policy instance 2
Insurance contract or identification number520195
Number of Individuals Covered79
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $6,670
Total amount of fees paid to insurance companyUSD $3,266
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,863
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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