401k Plan data: DG AMERICAS INC. HEALTH & WELFARE PLAN plan

DG AMERICAS INC. HEALTH & WELFARE PLAN 401k Plan overview

Plan Name	DG AMERICAS INC. HEALTH & WELFARE PLAN
Plan identification number	501

DG AMERICAS INC. HEALTH & WELFARE 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) Other welfare benefit cover

401k Sponsoring company profile

DG AMERICAS INC. has sponsored the creation of one or more 401k plans.

Company Name: DG AMERICAS INC.

Employer identification number (EIN): 042953448

NAIC Classification: 323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DG AMERICAS INC. HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-09-01 MILQUIS FLORES
501 2022-09-01
501 2022-09-01 MILQUIS FLORES
501 2021-09-01
501 2021-09-01 LEAH EVANOSKI
501 2020-09-01
501 2020-01-01
501 2019-01-01 DARCY DUVALL 2020-05-07
501 2017-01-01
501 2016-01-01 DARCY DUVALL
501 2013-01-01 WAIN YARBER
501 2012-01-01 NORMA POPE
501 2011-01-01 NORMA POPE
501 2010-01-01 NORMA POPE

Plan Statistics for DG AMERICAS INC. HEALTH & WELFARE PLAN

401k plan membership statisitcs for DG AMERICAS INC. HEALTH & WELFARE PLAN

Measure Date Value
2022: DG AMERICAS INC. HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-09-01 1,637
Total number of active participants reported on line 7a of the Form 5500 2022-09-01 1,434
Number of retired or separated participants receiving benefits 2022-09-01 0
Number of other retired or separated participants entitled to future benefits 2022-09-01 0
Total of all active and inactive participants 2022-09-01 1,434
2021: DG AMERICAS INC. HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-09-01 1,843
Total number of active participants reported on line 7a of the Form 5500 2021-09-01 1,637
Number of retired or separated participants receiving benefits 2021-09-01 0
Number of other retired or separated participants entitled to future benefits 2021-09-01 0
Total of all active and inactive participants 2021-09-01 1,637
2020: DG AMERICAS INC. HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-09-01 1,352
Total number of active participants reported on line 7a of the Form 5500 2020-09-01 1,818
Number of retired or separated participants receiving benefits 2020-09-01 25
Number of other retired or separated participants entitled to future benefits 2020-09-01 0
Total of all active and inactive participants 2020-09-01 1,843
Total participants, beginning-of-year 2020-01-01 178
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
2019: DG AMERICAS INC. HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 246
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 178
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 178
Number of employers contributing to the scheme 2019-01-01 0
2017: DG AMERICAS INC. HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 253
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 253
2016: DG AMERICAS INC. HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 203
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 203
2013: DG AMERICAS INC. HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 158
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 177
Total of all active and inactive participants 2013-01-01 177
Total participants 2013-01-01 0
2012: DG AMERICAS INC. HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 158
Total of all active and inactive participants 2012-01-01 158
Total participants 2012-01-01 0
2011: DG AMERICAS INC. HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 152
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 151
Total of all active and inactive participants 2011-01-01 151
Total participants 2011-01-01 151
2010: DG AMERICAS INC. HEALTH & WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 152
Total of all active and inactive participants 2010-01-01 152
Total participants 2010-01-01 152

Measure	Date	Value
2022: DG AMERICAS INC. HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-09-01	1,637
Total number of active participants reported on line 7a of the Form 5500	2022-09-01	1,434
Number of retired or separated participants receiving benefits	2022-09-01	0
Number of other retired or separated participants entitled to future benefits	2022-09-01	0
Total of all active and inactive participants	2022-09-01	1,434
2021: DG AMERICAS INC. HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-09-01	1,843
Total number of active participants reported on line 7a of the Form 5500	2021-09-01	1,637
Number of retired or separated participants receiving benefits	2021-09-01	0
Number of other retired or separated participants entitled to future benefits	2021-09-01	0
Total of all active and inactive participants	2021-09-01	1,637
2020: DG AMERICAS INC. HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-09-01	1,352
Total number of active participants reported on line 7a of the Form 5500	2020-09-01	1,818
Number of retired or separated participants receiving benefits	2020-09-01	25
Number of other retired or separated participants entitled to future benefits	2020-09-01	0
Total of all active and inactive participants	2020-09-01	1,843
Total participants, beginning-of-year	2020-01-01	178
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
2019: DG AMERICAS INC. HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	246
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	178
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	178
Number of employers contributing to the scheme	2019-01-01	0
2017: DG AMERICAS INC. HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	253
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	253
2016: DG AMERICAS INC. HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	203
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	203
2013: DG AMERICAS INC. HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	177
Total of all active and inactive participants	2013-01-01	177
Total participants	2013-01-01	0
2012: DG AMERICAS INC. HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	158
Total of all active and inactive participants	2012-01-01	158
Total participants	2012-01-01	0
2011: DG AMERICAS INC. HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	152
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	151
Total of all active and inactive participants	2011-01-01	151
Total participants	2011-01-01	151
2010: DG AMERICAS INC. HEALTH & WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	152
Total of all active and inactive participants	2010-01-01	152
Total participants	2010-01-01	152

Form 5500 Responses for DG AMERICAS INC. HEALTH & WELFARE PLAN

2022: DG AMERICAS INC. HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-09-01	Type of plan entity	Single employer plan
2022-09-01	Submission has been amended	No
2022-09-01	This submission is the final filing	No
2022-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-09-01	Plan is a collectively bargained plan	No
2022-09-01	Plan funding arrangement – Insurance	Yes
2022-09-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-09-01	Plan benefit arrangement – Insurance	Yes
2022-09-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: DG AMERICAS INC. HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-09-01	Type of plan entity	Single employer plan
2021-09-01	Submission has been amended	No
2021-09-01	This submission is the final filing	No
2021-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-09-01	Plan is a collectively bargained plan	No
2021-09-01	Plan funding arrangement – Insurance	Yes
2021-09-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-09-01	Plan benefit arrangement – Insurance	Yes
2021-09-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: DG AMERICAS INC. HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-09-01	Type of plan entity	Single employer plan
2020-09-01	Submission has been amended	No
2020-09-01	This submission is the final filing	No
2020-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-09-01	Plan is a collectively bargained plan	No
2020-09-01	Plan funding arrangement – Insurance	Yes
2020-09-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-09-01	Plan benefit arrangement – Insurance	Yes
2020-09-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	Yes
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: DG AMERICAS INC. HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: DG AMERICAS INC. HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: DG AMERICAS INC. HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2013: DG AMERICAS INC. HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: DG AMERICAS INC. HEALTH & WELFARE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: DG AMERICAS INC. HEALTH & WELFARE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: DG AMERICAS INC. HEALTH & WELFARE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	69291-3
Policy instance	9
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number	10116796
Policy instance	1
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	05686
Policy instance	2
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADDN14286457
Policy instance	3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	9757345*
Policy instance	4
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	69431-2
Policy instance	5
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number	159835
Policy instance	6
GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )
Policy contract number	10116796
Policy instance	7
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 54704 )
Policy contract number	0000026470
Policy instance	8
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 54704 )
Policy contract number	0000026470
Policy instance	4
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number	10116796
Policy instance	5
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	69291-3
Policy instance	6
GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )
Policy contract number	10116796
Policy instance	7
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	69431-2
Policy instance	8
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number	159835
Policy instance	9
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	9757345*
Policy instance	3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	05686
Policy instance	2
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADDN14286457
Policy instance	1
GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 )
Policy contract number	10116796
Policy instance	1
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	69291-3
Policy instance	2
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	69431-2
Policy instance	3
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 54704 )
Policy contract number	0000026470
Policy instance	4
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADDN14286457
Policy instance	5
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number	159835
Policy instance	6
GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 )
Policy contract number	10116796
Policy instance	7
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	9757345
Policy instance	8
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	769037
Policy instance	1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	540191
Policy instance	2
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	540191
Policy instance	2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	769037
Policy instance	1
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract number	1022116
Policy instance	3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract number	1022116
Policy instance	2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TSO5925623
Policy instance	1

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Company Name:	DG AMERICAS INC.
Employer identification number (EIN):	042953448
NAIC Classification:	323100

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-09-01	MILQUIS FLORES
501	2022-09-01
501	2022-09-01	MILQUIS FLORES
501	2021-09-01
501	2021-09-01	LEAH EVANOSKI
501	2020-09-01
501	2020-01-01
501	2019-01-01	DARCY DUVALL	2020-05-07
501	2017-01-01
501	2016-01-01	DARCY DUVALL
501	2013-01-01	WAIN YARBER
501	2012-01-01	NORMA POPE
501	2011-01-01	NORMA POPE
501	2010-01-01	NORMA POPE