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PETERMAN LUMBER HEALTH AND WELFARE PLAN 401k Plan overview

Plan NamePETERMAN LUMBER HEALTH AND WELFARE PLAN
Plan identification number 501

PETERMAN LUMBER HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)
  • 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

PETERMAN LUMBER. INC. has sponsored the creation of one or more 401k plans.

Company Name:PETERMAN LUMBER. INC.
Employer identification number (EIN):953383921
NAIC Classification:423300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PETERMAN LUMBER HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-06-01RHONDA FLAMMA2024-12-02
5012022-06-01RHONDA FLAMMA2023-11-06
5012021-06-01RHONDA FLAMMA2022-10-25
5012020-06-01RHONDA FLAMMA2021-12-07

Plan Statistics for PETERMAN LUMBER HEALTH AND WELFARE PLAN

401k plan membership statisitcs for PETERMAN LUMBER HEALTH AND WELFARE PLAN

Measure Date Value
2023: PETERMAN LUMBER HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-06-01102
Total number of active participants reported on line 7a of the Form 55002023-06-0196
Number of retired or separated participants receiving benefits2023-06-011
Number of other retired or separated participants entitled to future benefits2023-06-010
Total of all active and inactive participants2023-06-0197
Number of employers contributing to the scheme2023-06-010
2022: PETERMAN LUMBER HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01153
Total number of active participants reported on line 7a of the Form 55002022-06-0169
Number of retired or separated participants receiving benefits2022-06-010
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-0169
Number of employers contributing to the scheme2022-06-010
2021: PETERMAN LUMBER HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01141
Total number of active participants reported on line 7a of the Form 55002021-06-01153
Number of retired or separated participants receiving benefits2021-06-010
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01153
Number of employers contributing to the scheme2021-06-010
2020: PETERMAN LUMBER HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01100
Total number of active participants reported on line 7a of the Form 55002020-06-0157
Number of retired or separated participants receiving benefits2020-06-010
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-0157
Number of employers contributing to the scheme2020-06-010

Form 5500 Responses for PETERMAN LUMBER HEALTH AND WELFARE PLAN

2023: PETERMAN LUMBER HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-06-01Type of plan entitySingle employer plan
2023-06-01Plan funding arrangement – InsuranceYes
2023-06-01Plan benefit arrangement – InsuranceYes
2022: PETERMAN LUMBER HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – InsuranceYes
2021: PETERMAN LUMBER HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes
2020: PETERMAN LUMBER HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01First time form 5500 has been submittedYes
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number165450BH
Policy instance 5
Insurance contract or identification number165450BH
Number of Individuals Covered7
Insurance policy start date2023-06-01
Insurance policy end date2024-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number165450HNO
Policy instance 4
Insurance contract or identification number165450HNO
Number of Individuals Covered32
Insurance policy start date2023-06-01
Insurance policy end date2024-05-31
Total amount of commissions paid to insurance brokerUSD $10,836
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $213,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number940407
Policy instance 3
Insurance contract or identification number940407
Number of Individuals Covered162
Insurance policy start date2023-06-01
Insurance policy end date2024-05-31
Total amount of commissions paid to insurance brokerUSD $14,562
Total amount of fees paid to insurance companyUSD $1,987
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $125,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number136838
Policy instance 2
Insurance contract or identification number136838
Number of Individuals Covered63
Insurance policy start date2023-06-01
Insurance policy end date2024-05-31
Total amount of commissions paid to insurance brokerUSD $23,411
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $467,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number165450
Policy instance 1
Insurance contract or identification number165450
Number of Individuals Covered22
Insurance policy start date2023-06-01
Insurance policy end date2024-05-31
Total amount of commissions paid to insurance brokerUSD $8,316
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number165450BH
Policy instance 5
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number165450HNO
Policy instance 4
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number940407
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number136838
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number165450
Policy instance 1
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number165450BH
Policy instance 5
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number165450HNO
Policy instance 4
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number940407
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number136838
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number165450
Policy instance 1
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number165450HNO
Policy instance 4
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number940407
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number136838
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number165450
Policy instance 1

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