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ANTHEM BLUE CROSS AND BLUE SHIELD 401k Plan overview

Plan NameANTHEM BLUE CROSS AND BLUE SHIELD
Plan identification number 501

ANTHEM BLUE CROSS AND BLUE SHIELD Benefits

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

401k Sponsoring company profile

BARRYS BOOTCAMP has sponsored the creation of one or more 401k plans.

Company Name:BARRYS BOOTCAMP
Employer identification number (EIN):474580511
NAIC Classification:446190

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ANTHEM BLUE CROSS AND BLUE SHIELD

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-03-01CORINNE PRUDHOMME2020-09-21
5012018-03-01BRANDY NOLE2019-12-10
5012017-03-01

Plan Statistics for ANTHEM BLUE CROSS AND BLUE SHIELD

401k plan membership statisitcs for ANTHEM BLUE CROSS AND BLUE SHIELD

Measure Date Value
2019: ANTHEM BLUE CROSS AND BLUE SHIELD 2019 401k membership
Total participants, beginning-of-year2019-03-01302
Total number of active participants reported on line 7a of the Form 55002019-03-01302
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-01302
Number of employers contributing to the scheme2019-03-010
2018: ANTHEM BLUE CROSS AND BLUE SHIELD 2018 401k membership
Total participants, beginning-of-year2018-03-01147
Total number of active participants reported on line 7a of the Form 55002018-03-01185
Number of retired or separated participants receiving benefits2018-03-010
Number of other retired or separated participants entitled to future benefits2018-03-010
Total of all active and inactive participants2018-03-01185
Number of employers contributing to the scheme2018-03-010
2017: ANTHEM BLUE CROSS AND BLUE SHIELD 2017 401k membership
Total participants, beginning-of-year2017-03-01100
Total number of active participants reported on line 7a of the Form 55002017-03-01147
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-01147

Form 5500 Responses for ANTHEM BLUE CROSS AND BLUE SHIELD

2019: ANTHEM BLUE CROSS AND BLUE SHIELD 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: ANTHEM BLUE CROSS AND BLUE SHIELD 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: ANTHEM BLUE CROSS AND BLUE SHIELD 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01First time form 5500 has been submittedYes
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: )
Policy contract number281148
Policy instance 1
Insurance contract or identification number281148
Number of Individuals Covered302
Insurance policy start date2019-03-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $105,026
Total amount of fees paid to insurance companyUSD $4,156
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,251,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $105,026
Amount paid for insurance broker fees3180
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: )
Policy contract number281148
Policy instance 1
Insurance contract or identification number281148
Number of Individuals Covered185
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $58,552
Total amount of fees paid to insurance companyUSD $6,492
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,078,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,279
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: )
Policy contract number281148
Policy instance 1
Insurance contract or identification number281148
Number of Individuals Covered163
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $38,407
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $815,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,407
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMARSH AND MCLENNAN AGENCY

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