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| Plan Name | BAZELLA WORKS, LLC GROUP MEDICAL PLAN 502 |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BAZELLA WORKS |
| Employer identification number (EIN): | 825235939 |
| NAIC Classification: | 238100 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2023-03-01 |
| Measure | Date | Value |
|---|---|---|
| 2023: BAZELLA WORKS, LLC GROUP MEDICAL PLAN 502 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-03-01 | 70 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-03-01 | 79 |
| Number of retired or separated participants receiving benefits | 2023-03-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2023-03-01 | 0 |
| Total of all active and inactive participants | 2023-03-01 | 80 |
| Measure | Date | Value |
|---|---|---|
| 2023 : BAZELLA WORKS, LLC GROUP MEDICAL PLAN 502 2023 401k financial data | ||
| Total plan liabilities at end of year | 2023-12-31 | $41,618 |
| Total plan liabilities at beginning of year | 2023-12-31 | $0 |
| Total income from all sources | 2023-12-31 | $573,708 |
| Expenses. Total of all expenses incurred | 2023-12-31 | $561,270 |
| Benefits paid (including direct rollovers) | 2023-12-31 | $286,946 |
| Total plan assets at end of year | 2023-12-31 | $54,056 |
| Total plan assets at beginning of year | 2023-12-31 | $0 |
| Value of fidelity bond covering the plan | 2023-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2023-12-31 | $3,999,485 |
| Expenses. Other expenses not covered elsewhere | 2023-12-31 | $274,324 |
| Contributions received from other sources (not participants or employers) | 2023-12-31 | $167 |
| Other income received | 2023-12-31 | $944 |
| Net income (gross income less expenses) | 2023-12-31 | $12,438 |
| Net plan assets at end of year (total assets less liabilities) | 2023-12-31 | $12,438 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2023-12-31 | $-3,426,888 |
| Value of corrective distributions | 2023-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2023-12-31 | $0 |
| 2023: BAZELLA WORKS, LLC GROUP MEDICAL PLAN 502 2023 form 5500 responses | ||
|---|---|---|
| 2023-03-01 | Type of plan entity | Single employer plan |
| 2023-03-01 | First time form 5500 has been submitted | Yes |
| 2023-03-01 | Submission has been amended | No |
| 2023-03-01 | This submission is the final filing | No |
| 2023-03-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2023-03-01 | Plan is a collectively bargained plan | No |
| 2023-03-01 | Plan funding arrangement – Insurance | Yes |
| 2023-03-01 | Plan funding arrangement – Trust | Yes |
| 2023-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-03-01 | Plan benefit arrangement - Trust | Yes |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) | |||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 408479-A | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||
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