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HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN 401k Plan overview

Plan NameHUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN
Plan identification number 502

HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN Benefits

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

401k Sponsoring company profile

HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name:HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC
Employer identification number (EIN):320069084
NAIC Classification:445310
NAIC Description:Beer, Wine, and Liquor Stores

Additional information about HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC

Jurisdiction of Incorporation: Michigan Department of Licensing & Regulatory Affairs
Incorporation Date:
Company Identification Number: B1489J

More information about HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-12-01SCOTT D. JOHNSON2023-05-24
5022020-12-01SCOTT D. JOHNSON2022-09-12

Plan Statistics for HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN

401k plan membership statisitcs for HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN

Measure Date Value
2021: HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-01188
Total number of active participants reported on line 7a of the Form 55002021-12-010
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-010
Number of employers contributing to the scheme2021-12-010
2020: HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01188
Total number of active participants reported on line 7a of the Form 55002020-12-010
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-010
Number of employers contributing to the scheme2020-12-010

Form 5500 Responses for HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN

2021: HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01This submission is the final filingYes
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – InsuranceYes
2020: HUDSONVILLE CREAMERY AND ICE CREAM COMPANY, LLC LIFE AND DISABILITY PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01First time form 5500 has been submittedYes
2020-12-01This submission is the final filingYes
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0C23S
Policy instance 1
Insurance contract or identification numberGLUG0C23S
Number of Individuals Covered263
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $8,039
Total amount of fees paid to insurance companyUSD $528
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $226,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,039
Amount paid for insurance broker fees528
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number532300
Policy instance 1
Insurance contract or identification number532300
Number of Individuals Covered188
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $10,849
Total amount of fees paid to insurance companyUSD $1,662
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $86,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,160
Amount paid for insurance broker fees1662
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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