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LIFE INSURANCE 401k Plan overview

Plan NameLIFE INSURANCE
Plan identification number 501

LIFE INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

RICK BERRY, INC. has sponsored the creation of one or more 401k plans.

Company Name:RICK BERRY, INC.
Employer identification number (EIN):770342968
NAIC Classification:238300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-02-01CLAUDIA ROBLES2024-02-13
5012022-02-01CLAUDIA ROBLES2023-03-20
5012021-10-01CLAUDIA ROBLES2022-08-04
5012020-10-01CLAUDIA ROBLES2022-02-02
5012019-10-01CLAUDIA ROBLES2021-02-12
5012018-10-01CLAUDIA ROBLES2020-01-27
5012017-10-01CLAUDIA ROBLES2019-05-07

Plan Statistics for LIFE INSURANCE

401k plan membership statisitcs for LIFE INSURANCE

Measure Date Value
2023: LIFE INSURANCE 2023 401k membership
Total participants, beginning-of-year2023-02-01143
Total number of active participants reported on line 7a of the Form 55002023-02-01116
Number of retired or separated participants receiving benefits2023-02-010
Number of other retired or separated participants entitled to future benefits2023-02-010
Total of all active and inactive participants2023-02-01116
Number of employers contributing to the scheme2023-02-010
2022: LIFE INSURANCE 2022 401k membership
Total participants, beginning-of-year2022-02-01153
Total number of active participants reported on line 7a of the Form 55002022-02-01143
Number of retired or separated participants receiving benefits2022-02-010
Number of other retired or separated participants entitled to future benefits2022-02-010
Total of all active and inactive participants2022-02-01143
Number of employers contributing to the scheme2022-02-010
2021: LIFE INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-10-01136
Total number of active participants reported on line 7a of the Form 55002021-10-01136
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01136
Number of employers contributing to the scheme2021-10-010
2020: LIFE INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-10-01173
Total number of active participants reported on line 7a of the Form 55002020-10-01173
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01173
Number of employers contributing to the scheme2020-10-010
2019: LIFE INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-10-01112
Total number of active participants reported on line 7a of the Form 55002019-10-01130
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01130
Number of employers contributing to the scheme2019-10-010
2018: LIFE INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-10-01145
Total number of active participants reported on line 7a of the Form 55002018-10-01112
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01112
Number of employers contributing to the scheme2018-10-010
2017: LIFE INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-10-01124
Total number of active participants reported on line 7a of the Form 55002017-10-01124
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01124
Number of employers contributing to the scheme2017-10-010

Form 5500 Responses for LIFE INSURANCE

2023: LIFE INSURANCE 2023 form 5500 responses
2023-02-01Type of plan entitySingle employer plan
2023-02-01Plan funding arrangement – InsuranceYes
2023-02-01Plan benefit arrangement – InsuranceYes
2022: LIFE INSURANCE 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Plan funding arrangement – InsuranceYes
2022-02-01Plan benefit arrangement – InsuranceYes
2021: LIFE INSURANCE 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – InsuranceYes
2020: LIFE INSURANCE 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: LIFE INSURANCE 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: LIFE INSURANCE 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: LIFE INSURANCE 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01First time form 5500 has been submittedYes
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number564897
Policy instance 1
Insurance contract or identification number564897
Number of Individuals Covered113
Insurance policy start date2023-02-01
Insurance policy end date2024-01-31
Total amount of commissions paid to insurance brokerUSD $3,742
Total amount of fees paid to insurance companyUSD $981
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $34,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number564897
Policy instance 1
Insurance contract or identification number564897
Number of Individuals Covered133
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $4,400
Total amount of fees paid to insurance companyUSD $831
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $41,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,400
Amount paid for insurance broker fees831
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number564897
Policy instance 1
Insurance contract or identification number564897
Number of Individuals Covered136
Insurance policy start date2021-10-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $133
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $133
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number564897
Policy instance 1
Insurance contract or identification number564897
Number of Individuals Covered124
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $559
Total amount of fees paid to insurance companyUSD $254
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,588
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $559
Amount paid for insurance broker fees254
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number564897
Policy instance 1
Insurance contract or identification number564897
Number of Individuals Covered130
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $509
Total amount of fees paid to insurance companyUSD $91
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $509
Amount paid for insurance broker fees91
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number40882
Policy instance 1
Insurance contract or identification number40882
Number of Individuals Covered112
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $566
Total amount of fees paid to insurance companyUSD $169
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $388
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOVERRIDE
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number40882
Policy instance 1
Insurance contract or identification number40882
Number of Individuals Covered124
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $722
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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