401k Plan data: FLAGG BICYCLE GROUP, LLC BENEFIT PLAN plan

FLAGG BICYCLE GROUP, LLC BENEFIT PLAN 401k Plan overview

Plan Name	FLAGG BICYCLE GROUP, LLC BENEFIT PLAN
Plan identification number	501

FLAGG BICYCLE GROUP, LLC BENEFIT PLAN Benefits

401k Plan Type	Welfare 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

FLAGG BICYCLE GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name: FLAGG BICYCLE GROUP, LLC

Employer identification number (EIN): 882054757

NAIC Classification: 423910
NAIC Description: Sporting and Recreational Goods and Supplies Merchant Wholesalers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FLAGG BICYCLE GROUP, LLC BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 JERRY POMIJE 2024-07-29

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	JERRY POMIJE	2024-07-29

Form 5500 Responses for FLAGG BICYCLE GROUP, LLC BENEFIT PLAN

2023: FLAGG BICYCLE GROUP, LLC BENEFIT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

72391-6

Policy instance

Insurance contract or identification number	72391-6
Number of Individuals Covered	650
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $20,119
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $329,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COUNSELING GLOBAL DOMESTIC (National Association of Insurance Commissioners NAIC id number: 54161 )

Policy contract number

401884

Policy instance

Insurance contract or identification number	401884
Number of Individuals Covered	700
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $18,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

98578891001

Policy instance

Insurance contract or identification number	98578891001
Number of Individuals Covered	622
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $2,944
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Welfare Benefit Premiums Paid to Carrier	USD $40,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	FLAGG BICYCLE GROUP, LLC
Employer identification number (EIN):	882054757
NAIC Classification:	423910
NAIC Description:	Sporting and Recreational Goods and Supplies Merchant Wholesalers