401k Plan data: BOLTON CONSTRUCTION GROUP HEALTH PLAN plan

BOLTON CONSTRUCTION GROUP HEALTH PLAN 401k Plan overview

Plan Name	BOLTON CONSTRUCTION GROUP HEALTH PLAN
Plan identification number	501

BOLTON CONSTRUCTION GROUP HEALTH 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

401k Sponsoring company profile

BOLTON CONSTRUCTION & SERVICE OF WNC, INC. has sponsored the creation of one or more 401k plans.

Company Name: BOLTON CONSTRUCTION & SERVICE OF WNC, INC.

Employer identification number (EIN): 710922928

NAIC Classification: 238220
NAIC Description: Plumbing, Heating, and Air-Conditioning Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOLTON CONSTRUCTION GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-04-01
501 2023-04-01 MARK BOLTON
501 2022-04-01
501 2022-04-01 MARK BOLTON
501 2021-04-01
501 2021-04-01 MARK BOLTON
501 2020-04-01
501 2019-04-01
501 2018-04-01
501 2017-04-01 MARK BOLTON
501 2016-04-01 WILLIAM E. BOLTON, III
501 2015-04-01 WILLIAM E. BOLTON, III
501 2014-04-01 WILLIAM E. BOLTON, III
501 2013-04-01 WILLIAM E. BOLTON, III
501 2012-04-01 WILLIAM E. BOLTON, III
501 2011-04-01 WILLIAM E. BOLTON, III
501 2009-04-01 WILLIAM E. BOLTON, III
501 2008-04-01 WILLIAM E BOLTON, III
501 2007-04-01 WILLIAM E BOLTON, III

Form 5500 Responses for BOLTON CONSTRUCTION GROUP HEALTH PLAN

2023: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2023 form 5500 responses
2023-04-01	Type of plan entity	Single employer plan
2023-04-01	Plan funding arrangement – Insurance	Yes
2023-04-01	Plan benefit arrangement – Insurance	Yes
2022: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2022 form 5500 responses
2022-04-01	Type of plan entity	Single employer plan
2022-04-01	Plan funding arrangement – Insurance	Yes
2022-04-01	Plan benefit arrangement – Insurance	Yes
2021: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2021 form 5500 responses
2021-04-01	Type of plan entity	Single employer plan
2021-04-01	Plan funding arrangement – Insurance	Yes
2021-04-01	Plan benefit arrangement – Insurance	Yes
2020: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2020 form 5500 responses
2020-04-01	Type of plan entity	Single employer plan
2020-04-01	Plan funding arrangement – Insurance	Yes
2020-04-01	Plan benefit arrangement – Insurance	Yes
2019: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2019 form 5500 responses
2019-04-01	Type of plan entity	Single employer plan
2019-04-01	Plan funding arrangement – Insurance	Yes
2019-04-01	Plan benefit arrangement – Insurance	Yes
2018: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2018 form 5500 responses
2018-04-01	Type of plan entity	Single employer plan
2018-04-01	Plan funding arrangement – Insurance	Yes
2018-04-01	Plan benefit arrangement – Insurance	Yes
2017: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2017 form 5500 responses
2017-04-01	Type of plan entity	Single employer plan
2017-04-01	Plan funding arrangement – Insurance	Yes
2017-04-01	Plan benefit arrangement – Insurance	Yes
2016: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	Plan funding arrangement – Insurance	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes
2015: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2015 form 5500 responses
2015-04-01	Type of plan entity	Single employer plan
2015-04-01	Plan funding arrangement – Insurance	Yes
2015-04-01	Plan benefit arrangement – Insurance	Yes
2014: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2014 form 5500 responses
2014-04-01	Type of plan entity	Single employer plan
2014-04-01	Plan funding arrangement – Insurance	Yes
2014-04-01	Plan benefit arrangement – Insurance	Yes
2013: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2013 form 5500 responses
2013-04-01	Type of plan entity	Single employer plan
2013-04-01	Plan funding arrangement – Insurance	Yes
2013-04-01	Plan benefit arrangement – Insurance	Yes
2012: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2012 form 5500 responses
2012-04-01	Type of plan entity	Single employer plan
2012-04-01	Plan funding arrangement – Insurance	Yes
2012-04-01	Plan benefit arrangement – Insurance	Yes
2011: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2011 form 5500 responses
2011-04-01	Type of plan entity	Single employer plan
2011-04-01	Plan funding arrangement – Insurance	Yes
2011-04-01	Plan benefit arrangement – Insurance	Yes
2009: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2009 form 5500 responses
2009-04-01	Type of plan entity	Single employer plan
2009-04-01	This submission is the final filing	No
2009-04-01	Plan funding arrangement – Insurance	Yes
2009-04-01	Plan benefit arrangement – Insurance	Yes
2008: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2008 form 5500 responses
2008-04-01	Type of plan entity	Single employer plan
2008-04-01	This submission is the final filing	No
2008-04-01	Plan funding arrangement – Insurance	Yes
2008-04-01	Plan benefit arrangement – Insurance	Yes
2007: BOLTON CONSTRUCTION GROUP HEALTH PLAN 2007 form 5500 responses
2007-04-01	Type of plan entity	Single employer plan
2007-04-01	This submission is the final filing	No
2007-04-01	Plan funding arrangement – Insurance	Yes
2007-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

Insurance contract or identification number	G000C3RB
Number of Individuals Covered	54
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $716
Total amount of fees paid to insurance company	USD $358
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

Insurance contract or identification number	G000C3RB
Number of Individuals Covered	31
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $3,882
Total amount of fees paid to insurance company	USD $971
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

Insurance contract or identification number	G000C3RB
Number of Individuals Covered	67
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $559
Total amount of fees paid to insurance company	USD $699
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $13,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

Insurance contract or identification number	G000C3RB
Number of Individuals Covered	97
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $1,162
Total amount of fees paid to insurance company	USD $581
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

Insurance contract or identification number	G000C3RB
Number of Individuals Covered	97
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of fees paid to insurance company	USD $653
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

00635942

Policy instance

Insurance contract or identification number	00635942
Number of Individuals Covered	91
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $30,340
Total amount of fees paid to insurance company	USD $40,012
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	WELLNESS
Welfare Benefit Premiums Paid to Carrier	USD $227,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

00635942

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000C3RB

Policy instance

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1091523

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161231-1003

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161231-1001

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161231-1002

Policy instance

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1091523

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161231-1003

Policy instance

BLUE CROSS BLUE SHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161231-1002

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

14161231-1001

Policy instance

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1091523

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073952

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073952

Policy instance

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1091523

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073952

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073952

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073952

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50020182

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010139990

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073952

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

00001D021635

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010139992

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010139991

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073952

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000400001000

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010139992

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010139991

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073948

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

00001D021635

Policy instance

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

868633G

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073952

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010139990

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

00001D021635

Policy instance

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

868633G

Policy instance

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )

Policy contract number

010-035118

Policy instance

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

Policy contract number

521245

Policy instance

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

068482

Policy instance

Potentially related plans

BOLTON CONSTRUCTION & SERVICE, LLC 401(K) PLAN [EIN = 600000708]

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Company Name:	BOLTON CONSTRUCTION & SERVICE OF WNC, INC.
Employer identification number (EIN):	710922928
NAIC Classification:	238220
NAIC Description:	Plumbing, Heating, and Air-Conditioning Contractors

Plan id#	Filing Submission Date	Name of Administrator
501	2023-04-01
501	2023-04-01	MARK BOLTON
501	2022-04-01
501	2022-04-01	MARK BOLTON
501	2021-04-01
501	2021-04-01	MARK BOLTON
501	2020-04-01
501	2019-04-01
501	2018-04-01
501	2017-04-01	MARK BOLTON
501	2016-04-01	WILLIAM E. BOLTON, III
501	2015-04-01	WILLIAM E. BOLTON, III
501	2014-04-01	WILLIAM E. BOLTON, III
501	2013-04-01	WILLIAM E. BOLTON, III
501	2012-04-01	WILLIAM E. BOLTON, III
501	2011-04-01	WILLIAM E. BOLTON, III
501	2009-04-01	WILLIAM E. BOLTON, III
501	2008-04-01	WILLIAM E BOLTON, III
501	2007-04-01	WILLIAM E BOLTON, III