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BERGE FORD PREMIUM ONLY PLAN 401k Plan overview

Plan NameBERGE FORD PREMIUM ONLY PLAN
Plan identification number 501

BERGE FORD PREMIUM ONLY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BERGE FORD, INC. has sponsored the creation of one or more 401k plans.

Company Name:BERGE FORD, INC.
Employer identification number (EIN):860116457
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BERGE FORD PREMIUM ONLY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-10-01SCOTT E. ELLSWORTH2019-11-04
5012017-10-01
5012016-10-01
5012015-10-01SCOTT ELLSWORTH
5012014-10-01SCOTT ELLSWORTH
5012013-10-01SCOTT ELLSWORTH
5012013-01-01SCOTT ELLSWORTH
5012012-01-01CRAIG BERGE
5012011-01-01CRAIG BERGE
5012010-01-01CRAIG BERGE
5012009-01-01CRAIG BERGE

Plan Statistics for BERGE FORD PREMIUM ONLY PLAN

401k plan membership statisitcs for BERGE FORD PREMIUM ONLY PLAN

Measure Date Value
2018: BERGE FORD PREMIUM ONLY PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01162
Total number of active participants reported on line 7a of the Form 55002018-10-010
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-010
Number of employers contributing to the scheme2018-10-010
2017: BERGE FORD PREMIUM ONLY PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01143
Total number of active participants reported on line 7a of the Form 55002017-10-01162
Number of retired or separated participants receiving benefits2017-10-012
Number of other retired or separated participants entitled to future benefits2017-10-012
Total of all active and inactive participants2017-10-01166
Number of employers contributing to the scheme2017-10-010
2016: BERGE FORD PREMIUM ONLY PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01246
Total number of active participants reported on line 7a of the Form 55002016-10-01232
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01232
2015: BERGE FORD PREMIUM ONLY PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01228
Number of retired or separated participants receiving benefits2015-10-01246
Total of all active and inactive participants2015-10-01246
2014: BERGE FORD PREMIUM ONLY PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01227
Total number of active participants reported on line 7a of the Form 55002014-10-01228
Total of all active and inactive participants2014-10-01228
2013: BERGE FORD PREMIUM ONLY PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01144
Total number of active participants reported on line 7a of the Form 55002013-10-01227
Total of all active and inactive participants2013-10-01227
Total participants, beginning-of-year2013-01-01127
Total number of active participants reported on line 7a of the Form 55002013-01-01144
Total of all active and inactive participants2013-01-01144
2012: BERGE FORD PREMIUM ONLY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01144
Total number of active participants reported on line 7a of the Form 55002012-01-01125
Number of retired or separated participants receiving benefits2012-01-012
Total of all active and inactive participants2012-01-01127
2011: BERGE FORD PREMIUM ONLY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01161
Total number of active participants reported on line 7a of the Form 55002011-01-01144
Number of retired or separated participants receiving benefits2011-01-010
Total of all active and inactive participants2011-01-01144
2010: BERGE FORD PREMIUM ONLY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01210
Total number of active participants reported on line 7a of the Form 55002010-01-01161
Number of retired or separated participants receiving benefits2010-01-010
Total of all active and inactive participants2010-01-01161
2009: BERGE FORD PREMIUM ONLY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01164
Total number of active participants reported on line 7a of the Form 55002009-01-01209
Number of retired or separated participants receiving benefits2009-01-011
Total of all active and inactive participants2009-01-01210

Form 5500 Responses for BERGE FORD PREMIUM ONLY PLAN

2018: BERGE FORD PREMIUM ONLY PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01This submission is the final filingYes
2018-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: BERGE FORD PREMIUM ONLY PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: BERGE FORD PREMIUM ONLY PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: BERGE FORD PREMIUM ONLY PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: BERGE FORD PREMIUM ONLY PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes
2013: BERGE FORD PREMIUM ONLY PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-01-01Type of plan entitySingle employer plan
2013-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: BERGE FORD PREMIUM ONLY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: BERGE FORD PREMIUM ONLY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: BERGE FORD PREMIUM ONLY PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: BERGE FORD PREMIUM ONLY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number611892
Policy instance 1
Insurance contract or identification number611892
Number of Individuals Covered174
Insurance policy start date2018-10-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $536,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 )
Policy contract number10005548
Policy instance 2
Insurance contract or identification number10005548
Number of Individuals Covered124
Insurance policy start date2018-10-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $1,268
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,956
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,268
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B7VD
Policy instance 3
Insurance contract or identification numberGLUG0B7VD
Number of Individuals Covered163
Insurance policy start date2018-10-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $5,456
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $36,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,456
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number611892
Policy instance 1
Insurance contract or identification number611892
Number of Individuals Covered178
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,098
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,231,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 )
Policy contract number10005548
Policy instance 2
Insurance contract or identification number10005548
Number of Individuals Covered126
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $2,705
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,928
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 numberGLUG0B7VD
Policy instance 3
Insurance contract or identification numberGLUG0B7VD
Number of Individuals Covered149
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $12,322
Total amount of fees paid to insurance companyUSD $473
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $82,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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