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EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 401k Plan overview

Plan NameEMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN
Plan identification number 501

EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

EMERALD FOREST PRODUCTS has sponsored the creation of one or more 401k plans.

Company Name:EMERALD FOREST PRODUCTS
Employer identification number (EIN):931763216
NAIC Classification:321210

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-06-01LISA BAER LISA BAER2016-02-15
5012014-06-01LISA BAER LISA BAER2016-02-15
5012013-06-01SUE VICKERS SUE VICKERS2015-03-12

Plan Statistics for EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN

401k plan membership statisitcs for EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN

Measure Date Value
2015: EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01201
Total number of active participants reported on line 7a of the Form 55002015-06-01230
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-01230
2014: EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01201
Total number of active participants reported on line 7a of the Form 55002014-06-01201
Number of retired or separated participants receiving benefits2014-06-010
Number of other retired or separated participants entitled to future benefits2014-06-010
Total of all active and inactive participants2014-06-01201
2013: EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01179
Total number of active participants reported on line 7a of the Form 55002013-06-01201
Total of all active and inactive participants2013-06-01201

Form 5500 Responses for EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN

2015: EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR000090
Policy instance 1
Insurance contract or identification numberOR000090
Number of Individuals Covered233
Insurance policy start date2015-06-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $4,339
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,339
Insurance broker organization code?3
Insurance broker nameKPD INSURANCE INC
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR000090
Policy instance 1
Insurance contract or identification numberOR000090
Number of Individuals Covered242
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $2,149
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,149
Insurance broker organization code?3
Insurance broker nameKPD INSURANCE INC
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR000090
Policy instance 1
Insurance contract or identification numberOR000090
Number of Individuals Covered224
Insurance policy start date2013-06-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $221
Total amount of fees paid to insurance companyUSD $37
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $221
Amount paid for insurance broker fees37
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
Insurance broker nameKPD INSURANCE INC
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract numberG0021669
Policy instance 2
Insurance contract or identification numberG0021669
Number of Individuals Covered349
Insurance policy start date2013-06-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $4,351
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $114,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,351
Insurance broker organization code?3
Insurance broker name

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