401k Plan data: TRANS-PAK, INC EMPLOYEE DENTAL PLAN plan

TRANS-PAK, INC EMPLOYEE DENTAL PLAN 401k Plan overview

Plan Name	TRANS-PAK, INC EMPLOYEE DENTAL PLAN
Plan identification number	503

TRANS-PAK, INC EMPLOYEE DENTAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental 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

TRANS-PAK, INC. has sponsored the creation of one or more 401k plans.

Company Name: TRANS-PAK, INC.

Employer identification number (EIN): 941711977

NAIC Classification: 321900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRANS-PAK, INC EMPLOYEE DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2016-01-01 RAFAEL ZAMBRONO
503 2015-01-01 RAFAEL ZAMBRANO
503 2009-11-01 RAFAEL ZAMBRANO
503 2009-11-01 RAFAEL ZAMBRANO 2011-04-05
503 2009-01-01 RAFAEL ZAMBRANO

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2016-01-01	RAFAEL ZAMBRONO
503	2015-01-01	RAFAEL ZAMBRANO
503	2009-11-01	RAFAEL ZAMBRANO
503	2009-11-01		RAFAEL ZAMBRANO	2011-04-05
503	2009-01-01	RAFAEL ZAMBRANO

Plan Statistics for TRANS-PAK, INC EMPLOYEE DENTAL PLAN

401k plan membership statisitcs for TRANS-PAK, INC EMPLOYEE DENTAL PLAN

Measure Date Value
2016: TRANS-PAK, INC EMPLOYEE DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 172
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 78
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 78
2015: TRANS-PAK, INC EMPLOYEE DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 172
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 172
2009: TRANS-PAK, INC EMPLOYEE DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-11-01 124
Total number of active participants reported on line 7a of the Form 5500 2009-11-01 105
Number of retired or separated participants receiving benefits 2009-11-01 0
Number of other retired or separated participants entitled to future benefits 2009-11-01 0
Total of all active and inactive participants 2009-11-01 105
Total participants 2009-11-01 105
Total participants, beginning-of-year 2009-01-01 216
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 124
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 124
Total participants 2009-01-01 124

Measure	Date	Value
2016: TRANS-PAK, INC EMPLOYEE DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	172
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	78
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	78
2015: TRANS-PAK, INC EMPLOYEE DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	172
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	172
2009: TRANS-PAK, INC EMPLOYEE DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-11-01	124
Total number of active participants reported on line 7a of the Form 5500	2009-11-01	105
Number of retired or separated participants receiving benefits	2009-11-01	0
Number of other retired or separated participants entitled to future benefits	2009-11-01	0
Total of all active and inactive participants	2009-11-01	105
Total participants	2009-11-01	105
Total participants, beginning-of-year	2009-01-01	216
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	124
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	124
Total participants	2009-01-01	124

Form 5500 Responses for TRANS-PAK, INC EMPLOYEE DENTAL PLAN

2016: TRANS-PAK, INC EMPLOYEE DENTAL PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: TRANS-PAK, INC EMPLOYEE DENTAL PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2009: TRANS-PAK, INC EMPLOYEE DENTAL PLAN 2009 form 5500 responses
2009-11-01	Type of plan entity	Single employer plan
2009-11-01	Submission has been amended	Yes
2009-11-01	This submission is the final filing	No
2009-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-11-01	Plan is a collectively bargained plan	No
2009-11-01	Plan funding arrangement – Insurance	Yes
2009-11-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5372564

Policy instance

Insurance contract or identification number	5372564
Number of Individuals Covered	113
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,842
Total amount of fees paid to insurance company	USD $3,455
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $115,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,842
Insurance broker organization code?	3
Amount paid for insurance broker fees	3455
Additional information about fees paid to insurance broker	MARKETING FEE NON-MONETARY COMPENSATION PRODUCER BONUS PROGRAM PAYMENT
Insurance broker name	INTERWEST INSURANCE SERVICES, LLC

UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 )

Policy contract number

5372564

Policy instance

Insurance contract or identification number	5372564
Number of Individuals Covered	40
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $496
Total amount of fees paid to insurance company	USD $309
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $9,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $496
Insurance broker organization code?	3
Amount paid for insurance broker fees	309
Additional information about fees paid to insurance broker	MARKETING FEE NON-MONETARY COMPENSATION PRODUCER BONUS PROGRAM PAYMENT
Insurance broker name	INTERWEST INSURANCE SERVICES, LLC

UNITED DENTAL CARE OF TEXAS INC (National Association of Insurance Commissioners NAIC id number: 95142 )

Policy contract number

5372564

Policy instance

Insurance contract or identification number	5372564
Number of Individuals Covered	19
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $205
Total amount of fees paid to insurance company	USD $126
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $4,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $205
Insurance broker organization code?	3
Amount paid for insurance broker fees	126
Additional information about fees paid to insurance broker	MARKETING FEE NON-MONETARY COMPENSATION PRODUCER BONUS PROGRAM PAYMENT
Insurance broker name	INTERWEST INSURANCE SERVICES, LLC

UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 )

Policy contract number

5372564

Policy instance

Insurance contract or identification number	5372564
Number of Individuals Covered	97
Insurance policy start date	2010-11-01
Insurance policy end date	2011-10-31
Total amount of commissions paid to insurance broker	USD $1,312
Total amount of fees paid to insurance company	USD $134
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	TRANS-PAK, INC.
Employer identification number (EIN):	941711977
NAIC Classification:	321900