401k Plan data: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN plan

BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 401k Plan overview

Plan Name	BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN
Plan identification number	502

BERDON LLP MEDICAL & GROUP LIFE INSURANCE 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

BERDON LLP has sponsored the creation of one or more 401k plans.

Company Name: BERDON LLP

Employer identification number (EIN): 130485070

NAIC Classification: 541211
NAIC Description: Offices of Certified Public Accountants

Additional information about BERDON LLP

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1994-12-12

Company Identification Number: 1875201

Legal Registered Office Address: 283 washington avenue

ALBANY
United States of America (USA)
12206

More information about BERDON LLP

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2022-01-01
502 2022-01-01 MARK BOSSWICK
502 2021-01-01
502 2021-01-01 MARK BOSSWICK
502 2020-01-01
502 2019-01-01
502 2018-01-01 MARK BOSSWICK
502 2017-01-01 MARK BOSSWICK
502 2016-01-01 MARK BOSSWICK
502 2015-01-01 MARK BOSSWICK
502 2014-01-01 MARK BOSSWICK
502 2013-01-01
502 2012-01-01 MARK BOSSWICK
502 2011-01-01 MARK BOSSWICK
502 2009-01-01 THOMAS POLICANO

Form 5500 Responses for BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN

2022: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: BERDON LLP MEDICAL & GROUP LIFE INSURANCE 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 benefit arrangement – Insurance	Yes
2018: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: BERDON LLP MEDICAL & GROUP LIFE INSURANCE 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: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: BERDON LLP MEDICAL & GROUP LIFE INSURANCE 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: BERDON LLP MEDICAL & GROUP LIFE INSURANCE 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
2009: BERDON LLP MEDICAL & GROUP LIFE INSURANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

9907-23-44

Policy instance

Insurance contract or identification number	9907-23-44
Insurance policy start date	2022-01-30
Insurance policy end date	2022-05-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $296
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $1,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

70588

Policy instance

Insurance contract or identification number	70588
Number of Individuals Covered	377
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $21,135
Total amount of fees paid to insurance company	USD $69
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, DBL, AND PAID FAMILY LEAVE
Welfare Benefit Premiums Paid to Carrier	USD $535,984
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 number

919891

Policy instance

Insurance contract or identification number	919891
Number of Individuals Covered	584
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $5,175
Total amount of fees paid to insurance company	USD $5,422
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $181,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )

Policy contract number

300121

Policy instance

Insurance contract or identification number	300121
Number of Individuals Covered	290
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $845
Total amount of fees paid to insurance company	USD $256
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,464,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

9907-23-44

Policy instance

Insurance contract or identification number	9907-23-44
Insurance policy start date	2021-01-30
Insurance policy end date	2022-01-30
Total amount of commissions paid to insurance broker	USD $1,130
Total amount of fees paid to insurance company	USD $848
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $5,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

9907-23-44

Policy instance

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )

Policy contract number

300121

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

919891

Policy instance

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

70588

Policy instance

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

9907-23-44

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

225353

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

225283

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

632889

Policy instance

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )

Policy contract number

300121

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

912334

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

919891

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

912334

Policy instance

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )

Policy contract number

300121

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05948888

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

632889

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

225283

Policy instance

HM LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60213 )

Policy contract number

500292

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

225353

Policy instance

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

9907-23-44

Policy instance

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

9907-23-44

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

225353

Policy instance

HM LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60213 )

Policy contract number

500292

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

225283

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

632889

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05948888

Policy instance

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )

Policy contract number

300121

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00481998

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0755404

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

225353

Policy instance

HM LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60213 )

Policy contract number

500292

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

225283

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00507844

Policy instance

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

9907-23-44

Policy instance

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Company Name:	BERDON LLP
Employer identification number (EIN):	130485070
NAIC Classification:	541211
NAIC Description:	Offices of Certified Public Accountants

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1994-12-12
Company Identification Number:	1875201
Legal Registered Office Address:	283 washington avenue ALBANY United States of America (USA) 12206

Plan id#	Filing Submission Date	Name of Administrator
502	2022-01-01
502	2022-01-01	MARK BOSSWICK
502	2021-01-01
502	2021-01-01	MARK BOSSWICK
502	2020-01-01
502	2019-01-01
502	2018-01-01	MARK BOSSWICK
502	2017-01-01	MARK BOSSWICK
502	2016-01-01	MARK BOSSWICK
502	2015-01-01	MARK BOSSWICK
502	2014-01-01	MARK BOSSWICK
502	2013-01-01
502	2012-01-01	MARK BOSSWICK
502	2011-01-01	MARK BOSSWICK
502	2009-01-01	THOMAS POLICANO