401k Plan data: BASIC BENEFITS, LLC WELFARE BENEFIT PLAN plan

BASIC BENEFITS, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	BASIC BENEFITS, LLC WELFARE BENEFIT PLAN
Plan identification number	501

BASIC BENEFITS, LLC WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Vision

401k Sponsoring company profile

BASIC BENEFITS, LLC has sponsored the creation of one or more 401k plans.

Company Name: BASIC BENEFITS, LLC

Employer identification number (EIN): 834091544

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BASIC BENEFITS, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-01-01 JENNIFER LUCE 2020-10-04

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2019-01-01	JENNIFER LUCE	2020-10-04

Plan Statistics for BASIC BENEFITS, LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for BASIC BENEFITS, LLC WELFARE BENEFIT PLAN

Measure Date Value
2019: BASIC BENEFITS, LLC WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 121
Total of all active and inactive participants 2019-01-01 121

Measure	Date	Value
2019: BASIC BENEFITS, LLC WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	121
Total of all active and inactive participants	2019-01-01	121

Form 5500 Responses for BASIC BENEFITS, LLC WELFARE BENEFIT PLAN

2019: BASIC BENEFITS, LLC WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30053726

Policy instance

Insurance contract or identification number	30053726
Number of Individuals Covered	121
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,214
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $23,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,214
Insurance broker organization code?	3

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Company Name:	BASIC BENEFITS, LLC
Employer identification number (EIN):	834091544
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services