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HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 401k Plan overview

Plan NameHIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN
Plan identification number 501

HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare 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

HIGH COUNTRY BEVERAGE has sponsored the creation of one or more 401k plans.

Company Name:HIGH COUNTRY BEVERAGE
Employer identification number (EIN):841341843
NAIC Classification:424800

Additional information about HIGH COUNTRY BEVERAGE

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1996-04-16
Company Identification Number: 19961052436
Legal Registered Office Address: 4200 Ronald Reagan Blvd

Johnstown
United States of America (USA)
80534

More information about HIGH COUNTRY BEVERAGE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-08-01CHRIS GALBATE2023-12-12
5012021-08-01CHRIS GALBATE2022-12-07
5012020-08-01CHRIS GALBATE2022-04-08
5012019-08-01CHRIS GALBATE2021-01-25
5012018-08-01CHRIS GALBATE2020-05-01
5012017-08-01
5012016-08-01CHRIS GALBATE CHRIS GALBATE2018-02-12
5012015-08-01
5012015-08-01
5012014-08-01CHRIS GALBATE
5012014-08-01
5012013-08-01CHRIS GALBATE

Financial Data on HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN

Measure Date Value
2015 : HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-07-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-07-31$0
Total income from all sources (including contributions)2015-07-31$919,523
Total loss/gain on sale of assets2015-07-31$0
Total of all expenses incurred2015-07-31$919,523
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-07-31$603,845
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-07-31$919,523
Value of total assets at end of year2015-07-31$0
Value of total assets at beginning of year2015-07-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-07-31$315,678
Total interest from all sources2015-07-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-07-31No
Was this plan covered by a fidelity bond2015-07-31No
If this is an individual account plan, was there a blackout period2015-07-31No
Were there any nonexempt tranactions with any party-in-interest2015-07-31No
Administrative expenses (other) incurred2015-07-31$315,678
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-07-31No
Value of net income/loss2015-07-31$0
Value of net assets at end of year (total assets less liabilities)2015-07-31$0
Value of net assets at beginning of year (total assets less liabilities)2015-07-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-07-31No
Were any leases to which the plan was party in default or uncollectible2015-07-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-07-31$603,845
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-07-31No
Was there a failure to transmit to the plan any participant contributions2015-07-31No
Has the plan failed to provide any benefit when due under the plan2015-07-31No
Contributions received in cash from employer2015-07-31$919,523
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-07-31No
Did the plan have assets held for investment2015-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-07-31No

Form 5500 Responses for HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN

2022: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2022 form 5500 responses
2022-08-01Type of plan entitySingle employer plan
2022-08-01Plan funding arrangement – InsuranceYes
2022-08-01Plan funding arrangement – General assets of the sponsorYes
2022-08-01Plan benefit arrangement – InsuranceYes
2022-08-01Plan benefit arrangement – General assets of the sponsorYes
2021: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan funding arrangement – General assets of the sponsorYes
2021-08-01Plan benefit arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – General assets of the sponsorYes
2020: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan funding arrangement – General assets of the sponsorYes
2020-08-01Plan benefit arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – General assets of the sponsorYes
2019: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan funding arrangement – General assets of the sponsorYes
2019-08-01Plan benefit arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – General assets of the sponsorYes
2018: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan funding arrangement – General assets of the sponsorYes
2018-08-01Plan benefit arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – General assets of the sponsorYes
2017: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan funding arrangement – General assets of the sponsorYes
2017-08-01Plan benefit arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – General assets of the sponsorYes
2016: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)No
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – General assets of the sponsorYes
2016-08-01Plan benefit arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – General assets of the sponsorYes
2015: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedNo
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)No
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – General assets of the sponsorYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – General assets of the sponsorYes
2014: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement - TrustYes
2013: HIGH COUNTRY BEVERAGE CORP. LIFE INSURANCE PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01First time form 5500 has been submittedYes
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VISION CARE DIRECT OF KANSAS (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number12173
Policy instance 5
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30105719
Policy instance 4
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number952558
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number662222
Policy instance 2
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number22967
Policy instance 1
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number22967
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30105719
Policy instance 2
VISION CARE DIRECT OF KANSAS (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number12173
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number662222
Policy instance 4
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number22967
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99352481001
Policy instance 2
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number952558
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number952558
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99352481001
Policy instance 2
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number22967
Policy instance 3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )
Policy contract numberE3037041
Policy instance 4
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number22967
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99352481001
Policy instance 2
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number952558
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00469340
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number952558
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99352481001
Policy instance 3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number22967
Policy instance 4
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )
Policy contract numberE3037041
Policy instance 5
NATIONAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 82538 )
Policy contract number1779
Policy instance 1
NATIONAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 82538 )
Policy contract number1779
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00469340
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00469340
Policy instance 1

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