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CLUB ASSIST US HEALTH AND WELFARE PLANS 401k Plan overview

Plan NameCLUB ASSIST US HEALTH AND WELFARE PLANS
Plan identification number 501

CLUB ASSIST US HEALTH AND WELFARE PLANS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

CLUB ASSIST US, LLC has sponsored the creation of one or more 401k plans.

Company Name:CLUB ASSIST US, LLC
Employer identification number (EIN):980361710
NAIC Classification:423100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLUB ASSIST US HEALTH AND WELFARE PLANS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01JOHN TUTT2024-05-02
5012022-01-01MARCIE LUSHEN2023-09-26
5012021-07-01MARCIE LUSHEN2022-08-05
5012020-07-01MARCIE LUSHEN2022-02-04
5012019-07-01MARIA RANDALL2020-12-22
5012017-07-01
5012016-07-01
5012015-07-01MARIA RANDALL
5012014-07-01CATHY COOK
5012013-07-01KATHY FLORES
5012012-07-01LORI SHORT
5012011-07-01KATHY FLORES
5012010-07-01KATHY FLORES
5012009-07-01KATHY FLORES

Plan Statistics for CLUB ASSIST US HEALTH AND WELFARE PLANS

401k plan membership statisitcs for CLUB ASSIST US HEALTH AND WELFARE PLANS

Measure Date Value
2023: CLUB ASSIST US HEALTH AND WELFARE PLANS 2023 401k membership
Total participants, beginning-of-year2023-01-01157
Total number of active participants reported on line 7a of the Form 55002023-01-01144
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01144
Number of employers contributing to the scheme2023-01-010
2022: CLUB ASSIST US HEALTH AND WELFARE PLANS 2022 401k membership
Total participants, beginning-of-year2022-01-01227
Total number of active participants reported on line 7a of the Form 55002022-01-01157
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01157
Number of employers contributing to the scheme2022-01-010
2021: CLUB ASSIST US HEALTH AND WELFARE PLANS 2021 401k membership
Total participants, beginning-of-year2021-07-01236
Total number of active participants reported on line 7a of the Form 55002021-07-01226
Number of retired or separated participants receiving benefits2021-07-011
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01227
Number of employers contributing to the scheme2021-07-010
2020: CLUB ASSIST US HEALTH AND WELFARE PLANS 2020 401k membership
Total participants, beginning-of-year2020-07-01224
Total number of active participants reported on line 7a of the Form 55002020-07-01236
Number of retired or separated participants receiving benefits2020-07-014
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01240
2019: CLUB ASSIST US HEALTH AND WELFARE PLANS 2019 401k membership
Total participants, beginning-of-year2019-07-01208
Total number of active participants reported on line 7a of the Form 55002019-07-01224
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01224
Number of employers contributing to the scheme2019-07-010
2017: CLUB ASSIST US HEALTH AND WELFARE PLANS 2017 401k membership
Total participants, beginning-of-year2017-07-01177
Total number of active participants reported on line 7a of the Form 55002017-07-01196
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01196
2016: CLUB ASSIST US HEALTH AND WELFARE PLANS 2016 401k membership
Total participants, beginning-of-year2016-07-01175
Total number of active participants reported on line 7a of the Form 55002016-07-01177
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01177
2015: CLUB ASSIST US HEALTH AND WELFARE PLANS 2015 401k membership
Total participants, beginning-of-year2015-07-01193
Total number of active participants reported on line 7a of the Form 55002015-07-01175
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01175
2014: CLUB ASSIST US HEALTH AND WELFARE PLANS 2014 401k membership
Total participants, beginning-of-year2014-07-01152
Total number of active participants reported on line 7a of the Form 55002014-07-01146
Number of retired or separated participants receiving benefits2014-07-012
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01148
2013: CLUB ASSIST US HEALTH AND WELFARE PLANS 2013 401k membership
Total participants, beginning-of-year2013-07-01155
Total number of active participants reported on line 7a of the Form 55002013-07-01152
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01152
2012: CLUB ASSIST US HEALTH AND WELFARE PLANS 2012 401k membership
Total participants, beginning-of-year2012-07-01134
Total number of active participants reported on line 7a of the Form 55002012-07-01155
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01155
2011: CLUB ASSIST US HEALTH AND WELFARE PLANS 2011 401k membership
Total participants, beginning-of-year2011-07-01357
Total number of active participants reported on line 7a of the Form 55002011-07-01131
Number of retired or separated participants receiving benefits2011-07-013
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01134
2010: CLUB ASSIST US HEALTH AND WELFARE PLANS 2010 401k membership
Total participants, beginning-of-year2010-07-01208
Total number of active participants reported on line 7a of the Form 55002010-07-01354
Number of retired or separated participants receiving benefits2010-07-013
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01357
2009: CLUB ASSIST US HEALTH AND WELFARE PLANS 2009 401k membership
Total participants, beginning-of-year2009-07-01250
Total number of active participants reported on line 7a of the Form 55002009-07-01204
Number of retired or separated participants receiving benefits2009-07-014
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01208

Form 5500 Responses for CLUB ASSIST US HEALTH AND WELFARE PLANS

2023: CLUB ASSIST US HEALTH AND WELFARE PLANS 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: CLUB ASSIST US HEALTH AND WELFARE PLANS 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: CLUB ASSIST US HEALTH AND WELFARE PLANS 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: CLUB ASSIST US HEALTH AND WELFARE PLANS 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: CLUB ASSIST US HEALTH AND WELFARE PLANS 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: CLUB ASSIST US HEALTH AND WELFARE PLANS 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: CLUB ASSIST US HEALTH AND WELFARE PLANS 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: CLUB ASSIST US HEALTH AND WELFARE PLANS 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: CLUB ASSIST US HEALTH AND WELFARE PLANS 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: CLUB ASSIST US HEALTH AND WELFARE PLANS 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: CLUB ASSIST US HEALTH AND WELFARE PLANS 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – General assets of the sponsorYes
2011: CLUB ASSIST US HEALTH AND WELFARE PLANS 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: CLUB ASSIST US HEALTH AND WELFARE PLANS 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: CLUB ASSIST US HEALTH AND WELFARE PLANS 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM0612436
Policy instance 3
Insurance contract or identification numberSGM0612436
Number of Individuals Covered144
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $8,352
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $74,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number637528
Policy instance 2
Insurance contract or identification number637528
Number of Individuals Covered201
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $12,402
Total amount of fees paid to insurance companyUSD $43,871
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $1,445,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number204305
Policy instance 1
Insurance contract or identification number204305
Number of Individuals Covered21
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $542
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $3,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number917654
Policy instance 3
Insurance contract or identification number917654
Number of Individuals Covered272
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $25,048
Total amount of fees paid to insurance companyUSD $48,270
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,700,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number400200000
Policy instance 2
Insurance contract or identification number400200000
Number of Individuals Covered15
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,298
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
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
Other welfare benefits providedACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $11,979
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number204305
Policy instance 1
Insurance contract or identification number204305
Number of Individuals Covered161
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $677
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $3,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number917654
Policy instance 3
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number400200000
Policy instance 2
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number204305
Policy instance 1
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number204305
Policy instance 1
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number400200000
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number917654
Policy instance 3
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number149346
Policy instance 1
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number400200000
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number917654
Policy instance 3
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number400200000
Policy instance 4
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number149346
Policy instance 3
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number276606
Policy instance 2
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract numberACA5977081
Policy instance 1

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