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BROOKLYN BREWERY 401k Plan overview

Plan NameBROOKLYN BREWERY
Plan identification number 501

BROOKLYN BREWERY Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

BROOKLYN BREWERY CORP has sponsored the creation of one or more 401k plans.

Company Name:BROOKLYN BREWERY CORP
Employer identification number (EIN):113340913
NAIC Classification:312120
NAIC Description:Breweries

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BROOKLYN BREWERY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-11-01PATRICIA TAPIA2021-06-07
5012018-11-01SAMANTHA IRVIN2020-06-18
5012017-11-01SAMANTHA IRVIN2019-05-21
5012016-11-01
5012016-11-01SAMANTHA IRVIN2019-01-09

Plan Statistics for BROOKLYN BREWERY

401k plan membership statisitcs for BROOKLYN BREWERY

Measure Date Value
2019: BROOKLYN BREWERY 2019 401k membership
Total participants, beginning-of-year2019-11-01130
Total number of active participants reported on line 7a of the Form 55002019-11-0161
Number of retired or separated participants receiving benefits2019-11-010
Number of other retired or separated participants entitled to future benefits2019-11-010
Total of all active and inactive participants2019-11-0161
Number of employers contributing to the scheme2019-11-010
2018: BROOKLYN BREWERY 2018 401k membership
Total participants, beginning-of-year2018-11-01156
Total number of active participants reported on line 7a of the Form 55002018-11-01130
Number of retired or separated participants receiving benefits2018-11-010
Number of other retired or separated participants entitled to future benefits2018-11-010
Total of all active and inactive participants2018-11-01130
Number of employers contributing to the scheme2018-11-010
2017: BROOKLYN BREWERY 2017 401k membership
Total participants, beginning-of-year2017-11-01214
Total number of active participants reported on line 7a of the Form 55002017-11-01156
Number of retired or separated participants receiving benefits2017-11-010
Number of other retired or separated participants entitled to future benefits2017-11-010
Total of all active and inactive participants2017-11-01156
Number of employers contributing to the scheme2017-11-010
2016: BROOKLYN BREWERY 2016 401k membership
Total participants, beginning-of-year2016-11-01100
Total number of active participants reported on line 7a of the Form 55002016-11-01214
Number of retired or separated participants receiving benefits2016-11-010
Number of other retired or separated participants entitled to future benefits2016-11-010
Total of all active and inactive participants2016-11-01214
Number of employers contributing to the scheme2016-11-010

Form 5500 Responses for BROOKLYN BREWERY

2019: BROOKLYN BREWERY 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan funding arrangement – General assets of the sponsorYes
2019-11-01Plan benefit arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – General assets of the sponsorYes
2018: BROOKLYN BREWERY 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan funding arrangement – General assets of the sponsorYes
2018-11-01Plan benefit arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – General assets of the sponsorYes
2017: BROOKLYN BREWERY 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan funding arrangement – General assets of the sponsorYes
2017-11-01Plan benefit arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – General assets of the sponsorYes
2016: BROOKLYN BREWERY 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01First time form 5500 has been submittedYes
2016-11-01Submission has been amendedYes
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan funding arrangement – General assets of the sponsorYes
2016-11-01Plan benefit arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberNP148
Policy instance 1
Insurance contract or identification numberNP148
Number of Individuals Covered3
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $154
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $1,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number909544
Policy instance 2
Insurance contract or identification number909544
Number of Individuals Covered121
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $65,557
Total amount of fees paid to insurance companyUSD $3,162
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,340,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,191
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberBB22264
Policy instance 1
Insurance contract or identification numberBB22264
Number of Individuals Covered195
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $53,331
Total amount of fees paid to insurance companyUSD $19,166
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,626,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees19166
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberNP148
Policy instance 2
Insurance contract or identification numberNP148
Number of Individuals Covered3
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $154
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $2,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $62
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number909544
Policy instance 3
Insurance contract or identification number909544
Number of Individuals Covered195
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $17,566
Total amount of fees paid to insurance companyUSD $7,176
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $171,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,686
Amount paid for insurance broker fees7176
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberBB22264
Policy instance 1
Insurance contract or identification numberBB22264
Number of Individuals Covered214
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $56,684
Total amount of fees paid to insurance companyUSD $19,040
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,900,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberNP148
Policy instance 2
Insurance contract or identification numberNP148
Number of Individuals Covered4
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $197
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $2,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number909544
Policy instance 3
Insurance contract or identification number909544
Number of Individuals Covered196
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $8,721
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $84,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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