401k Plan data: BERTCH CABINET MFG INSURED BENEFITS PLAN plan

BERTCH CABINET MFG INSURED BENEFITS PLAN 401k Plan overview

Plan Name	BERTCH CABINET MFG INSURED BENEFITS PLAN
Plan identification number	503

BERTCH CABINET MFG INSURED BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BERTCH CABINET LLC has sponsored the creation of one or more 401k plans.

Company Name: BERTCH CABINET LLC

Employer identification number (EIN): 854340581

NAIC Classification: 337000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BERTCH CABINET MFG INSURED BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2021-01-01 ROBERT NELSON 2022-10-12
503 2021-01-01 ROBERT NELSON 2023-08-18

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2021-01-01	ROBERT NELSON	2022-10-12
503	2021-01-01	ROBERT NELSON	2023-08-18

Plan Statistics for BERTCH CABINET MFG INSURED BENEFITS PLAN

401k plan membership statisitcs for BERTCH CABINET MFG INSURED BENEFITS PLAN

Measure Date Value
2021: BERTCH CABINET MFG INSURED BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 673
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 0
Number of employers contributing to the scheme 2021-01-01 0

Measure	Date	Value
2021: BERTCH CABINET MFG INSURED BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	673
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	0
Number of employers contributing to the scheme	2021-01-01	0

Form 5500 Responses for BERTCH CABINET MFG INSURED BENEFITS PLAN

2021: BERTCH CABINET MFG INSURED BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	Yes
2021-01-01	This submission is the final filing	Yes
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )

Policy contract number

32383

Policy instance

Insurance contract or identification number	32383
Number of Individuals Covered	400
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $7,989
Total amount of fees paid to insurance company	USD $1,175
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $193,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,271
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	SALES AND PERSISTENCY BONUS

VERATRUS BUSINESS SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 13742 )

Policy contract number

32383

Policy instance

Insurance contract or identification number	32383
Number of Individuals Covered	125
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,739
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,735
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

GLUG0BGPQ

Policy instance

Insurance contract or identification number	GLUG0BGPQ
Number of Individuals Covered	560
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $13,190
Total amount of fees paid to insurance company	USD $12,021
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $145,330
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,190
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	OTHER COMPENSATION

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Company Name:	BERTCH CABINET LLC
Employer identification number (EIN):	854340581
NAIC Classification:	337000