401k Plan data: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN plan

SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN
Plan identification number	501

SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

SOUTH COAST BAKING has sponsored the creation of one or more 401k plans.

Company Name: SOUTH COAST BAKING

Employer identification number (EIN): 453954352

NAIC Classification: 445291
NAIC Description: Baked Goods Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-04-01
501 2020-04-01
501 2019-04-01

Plan Statistics for SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN

Measure Date Value
2021: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-04-01 43
Total number of active participants reported on line 7a of the Form 5500 2021-04-01 0
Number of retired or separated participants receiving benefits 2021-04-01 0
Number of other retired or separated participants entitled to future benefits 2021-04-01 0
Total of all active and inactive participants 2021-04-01 0
2020: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-04-01 55
Total number of active participants reported on line 7a of the Form 5500 2020-04-01 43
Number of retired or separated participants receiving benefits 2020-04-01 0
Number of other retired or separated participants entitled to future benefits 2020-04-01 0
Total of all active and inactive participants 2020-04-01 43
2019: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-04-01 53
Total number of active participants reported on line 7a of the Form 5500 2019-04-01 55
Number of retired or separated participants receiving benefits 2019-04-01 0
Number of other retired or separated participants entitled to future benefits 2019-04-01 0
Total of all active and inactive participants 2019-04-01 55

Measure	Date	Value
2021: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-04-01	43
Total number of active participants reported on line 7a of the Form 5500	2021-04-01	0
Number of retired or separated participants receiving benefits	2021-04-01	0
Number of other retired or separated participants entitled to future benefits	2021-04-01	0
Total of all active and inactive participants	2021-04-01	0
2020: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-04-01	55
Total number of active participants reported on line 7a of the Form 5500	2020-04-01	43
Number of retired or separated participants receiving benefits	2020-04-01	0
Number of other retired or separated participants entitled to future benefits	2020-04-01	0
Total of all active and inactive participants	2020-04-01	43
2019: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-04-01	53
Total number of active participants reported on line 7a of the Form 5500	2019-04-01	55
Number of retired or separated participants receiving benefits	2019-04-01	0
Number of other retired or separated participants entitled to future benefits	2019-04-01	0
Total of all active and inactive participants	2019-04-01	55

Form 5500 Responses for SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN

2021: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 2021 form 5500 responses
2021-04-01	Type of plan entity	Single employer plan
2021-04-01	This submission is the final filing	Yes
2021-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2021-04-01	Plan funding arrangement – Insurance	Yes
2021-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-04-01	Plan benefit arrangement – Insurance	Yes
2021-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 2020 form 5500 responses
2020-04-01	Type of plan entity	Single employer plan
2020-04-01	Plan funding arrangement – Insurance	Yes
2020-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-04-01	Plan benefit arrangement – Insurance	Yes
2020-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: SOUTH COAST BAKING EMPLOYEE BENEFITS PLAN 2019 form 5500 responses
2019-04-01	Type of plan entity	Single employer plan
2019-04-01	First time form 5500 has been submitted	Yes
2019-04-01	Plan funding arrangement – Insurance	Yes
2019-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-04-01	Plan benefit arrangement – Insurance	Yes
2019-04-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

168806

Policy instance

Insurance contract or identification number	168806
Insurance policy start date	2021-04-01
Insurance policy end date	2021-12-31
Total amount of fees paid to insurance company	USD $448
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	277
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

168806

Policy instance

Insurance contract or identification number	168806
Insurance policy start date	2021-04-01
Insurance policy end date	2021-12-31
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

168806

Policy instance

Insurance contract or identification number	168806
Insurance policy start date	2021-04-01
Insurance policy end date	2021-12-31
Total amount of fees paid to insurance company	USD $472
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	297
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )

Policy contract number

280449

Policy instance

Insurance contract or identification number	280449
Insurance policy start date	2021-04-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $3,353
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $317,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,353
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010261209

Policy instance

Insurance contract or identification number	000010261209
Number of Individuals Covered	24
Insurance policy start date	2020-04-01
Insurance policy end date	2021-03-31
Total amount of commissions paid to insurance broker	USD $71
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $58
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5957846

Policy instance

Insurance contract or identification number	5957846
Number of Individuals Covered	40
Insurance policy start date	2020-04-01
Insurance policy end date	2021-03-31
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,881
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010224422

Policy instance

Insurance contract or identification number	000010224422
Number of Individuals Covered	43
Insurance policy start date	2020-04-01
Insurance policy end date	2021-03-31
Total amount of commissions paid to insurance broker	USD $109
Total amount of fees paid to insurance company	USD $5
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $70
Insurance broker organization code?	3
Amount paid for insurance broker fees	5
Additional information about fees paid to insurance broker	BROKER BONUS

ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )

Policy contract number

280449

Policy instance

Insurance contract or identification number	280449
Number of Individuals Covered	26
Insurance policy start date	2020-04-01
Insurance policy end date	2021-03-31
Total amount of commissions paid to insurance broker	USD $12,521
Total amount of fees paid to insurance company	USD $389
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $217,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,172
Amount paid for insurance broker fees	389
Additional information about fees paid to insurance broker	INCENTIVES, EDUCATION, COMMUNICATION, TRAINING
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5957846

Policy instance

Insurance contract or identification number	5957846
Number of Individuals Covered	62
Insurance policy start date	2019-04-01
Insurance policy end date	2020-03-31
Total amount of commissions paid to insurance broker	USD $869
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $39,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $869
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010224422

Policy instance

Insurance contract or identification number	000010224422
Number of Individuals Covered	52
Insurance policy start date	2019-04-01
Insurance policy end date	2020-03-31
Total amount of fees paid to insurance company	USD $101
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	101
Additional information about fees paid to insurance broker	OVERRIDES BROKER BONUS
Insurance broker organization code?	3

ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )

Policy contract number

280449

Policy instance

Insurance contract or identification number	280449
Number of Individuals Covered	37
Insurance policy start date	2019-04-01
Insurance policy end date	2020-03-31
Total amount of commissions paid to insurance broker	USD $28,352
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,249,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $28,352
Insurance broker organization code?	3

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Company Name:	SOUTH COAST BAKING
Employer identification number (EIN):	453954352
NAIC Classification:	445291
NAIC Description:	Baked Goods Stores