401k Plan data: BAY PARK ORGANICS COOPERATIVE plan

BAY PARK ORGANICS COOPERATIVE 401k Plan overview

Plan Name	BAY PARK ORGANICS COOPERATIVE
Plan identification number	501

BAY PARK ORGANICS COOPERATIVE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BAY PARK ORGANICS COOPERATIVE has sponsored the creation of one or more 401k plans.

Company Name: BAY PARK ORGANICS COOPERATIVE

Employer identification number (EIN): 811331646

NAIC Classification: 453990

Additional information about BAY PARK ORGANICS COOPERATIVE

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: C3846515

More information about BAY PARK ORGANICS COOPERATIVE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BAY PARK ORGANICS COOPERATIVE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-05-01 DARCY BOGHDAN 2020-10-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2019-05-01	DARCY BOGHDAN	2020-10-21

Plan Statistics for BAY PARK ORGANICS COOPERATIVE

401k plan membership statisitcs for BAY PARK ORGANICS COOPERATIVE

Measure Date Value
2019: BAY PARK ORGANICS COOPERATIVE 2019 401k membership
Total participants, beginning-of-year 2019-05-01 100
Total number of active participants reported on line 7a of the Form 5500 2019-05-01 109
Number of retired or separated participants receiving benefits 2019-05-01 0
Number of other retired or separated participants entitled to future benefits 2019-05-01 0
Total of all active and inactive participants 2019-05-01 109
Number of employers contributing to the scheme 2019-05-01 0

Measure	Date	Value
2019: BAY PARK ORGANICS COOPERATIVE 2019 401k membership
Total participants, beginning-of-year	2019-05-01	100
Total number of active participants reported on line 7a of the Form 5500	2019-05-01	109
Number of retired or separated participants receiving benefits	2019-05-01	0
Number of other retired or separated participants entitled to future benefits	2019-05-01	0
Total of all active and inactive participants	2019-05-01	109
Number of employers contributing to the scheme	2019-05-01	0

Form 5500 Responses for BAY PARK ORGANICS COOPERATIVE

2019: BAY PARK ORGANICS COOPERATIVE 2019 form 5500 responses
2019-05-01	Type of plan entity	Single employer plan
2019-05-01	First time form 5500 has been submitted	Yes
2019-05-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-05-01	Plan funding arrangement – Insurance	Yes
2019-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )

Policy contract number

5951706

Policy instance

Insurance contract or identification number	5951706
Number of Individuals Covered	28
Insurance policy start date	2019-05-01
Insurance policy end date	2020-03-31
Total amount of commissions paid to insurance broker	USD $138
Total amount of fees paid to insurance company	USD $27
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $104
Amount paid for insurance broker fees	21
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

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

Policy contract number

914398

Policy instance

Insurance contract or identification number	914398
Number of Individuals Covered	66
Insurance policy start date	2019-05-01
Insurance policy end date	2020-03-31
Total amount of commissions paid to insurance broker	USD $15,157
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $234,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,931
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

5951706

Policy instance

Insurance contract or identification number	5951706
Number of Individuals Covered	255
Insurance policy start date	2019-05-01
Insurance policy end date	2020-03-31
Total amount of commissions paid to insurance broker	USD $2,905
Total amount of fees paid to insurance company	USD $359
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $42,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,408
Amount paid for insurance broker fees	206
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

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Company Name:	BAY PARK ORGANICS COOPERATIVE
Employer identification number (EIN):	811331646
NAIC Classification:	453990

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	C3846515