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FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL 401k Plan overview

Plan NameFRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL
Plan identification number 505

FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Severance pay
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

FRESH DIRECT HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name:FRESH DIRECT HOLDINGS, INC.
Employer identification number (EIN):113576952
NAIC Classification:551112
NAIC Description:Offices of Other Holding Companies

Additional information about FRESH DIRECT HOLDINGS, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3188643

More information about FRESH DIRECT HOLDINGS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-01-01DICKSON ALADESANMI2023-06-14
5052021-01-01ELIA CHAVEZ2022-09-26
5052020-01-01JOHN D. RAVENELLE2021-10-04

Plan Statistics for FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL

401k plan membership statisitcs for FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL

Measure Date Value
2022: FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL 2022 401k membership
Total participants, beginning-of-year2022-01-012,119
Total number of active participants reported on line 7a of the Form 55002022-01-013,026
Number of retired or separated participants receiving benefits2022-01-014
Number of other retired or separated participants entitled to future benefits2022-01-0117
Total of all active and inactive participants2022-01-013,047
Number of employers contributing to the scheme2022-01-010
2021: FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL 2021 401k membership
Total participants, beginning-of-year2021-01-01951
Total number of active participants reported on line 7a of the Form 55002021-01-01826
Number of retired or separated participants receiving benefits2021-01-015
Number of other retired or separated participants entitled to future benefits2021-01-0128
Total of all active and inactive participants2021-01-01859
Number of employers contributing to the scheme2021-01-010
2020: FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL 2020 401k membership
Total participants, beginning-of-year2020-01-01902
Total number of active participants reported on line 7a of the Form 55002020-01-01940
Number of retired or separated participants receiving benefits2020-01-0111
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01951
Number of employers contributing to the scheme2020-01-010

Form 5500 Responses for FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL

2022: FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: FRESH DIRECT HOLDINGS, LLC HEALTH AND WELFARE PLAN MEDICAL 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number300140
Policy instance 4
Insurance contract or identification number300140
Number of Individuals Covered810
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $32,590
Total amount of fees paid to insurance companyUSD $16,459
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $845,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,590
Amount paid for insurance broker fees16459
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 number570707
Policy instance 3
Insurance contract or identification number570707
Number of Individuals Covered578
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $55,971
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $248,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,899
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number803305G
Policy instance 2
Insurance contract or identification number803305G
Number of Individuals Covered587
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $34,083
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $227,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,083
Amount paid for insurance broker fees0
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 83399 )
Policy contract numberG000029112
Policy instance 1
Insurance contract or identification numberG000029112
Number of Individuals Covered637
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $50,418
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $330,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,305
Amount paid for insurance broker fees0
Insurance broker organization code?3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number300140
Policy instance 4
Insurance contract or identification number300140
Number of Individuals Covered1123
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $16,092
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $397,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,092
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 number570707
Policy instance 3
Insurance contract or identification number570707
Number of Individuals Covered680
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $87,001
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $174,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $87,001
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number803305G
Policy instance 2
Insurance contract or identification number803305G
Number of Individuals Covered733
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $40,534
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $270,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,534
Amount paid for insurance broker fees0
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 83399 )
Policy contract numberG000029112
Policy instance 1
Insurance contract or identification numberG000029112
Number of Individuals Covered702
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $96,467
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $326,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $78,979
Amount paid for insurance broker fees0
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberG000029112
Policy instance 4
Insurance contract or identification numberG000029112
Number of Individuals Covered940
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedLONG TERM CARE, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number744137
Policy instance 3
Insurance contract or identification number744137
Number of Individuals Covered940
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number473663
Policy instance 2
Insurance contract or identification number473663
Number of Individuals Covered940
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number181723
Policy instance 1
Insurance contract or identification number181723
Number of Individuals Covered940
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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