401k Plan data: PACIFIC MARITIME FREIGHT HEALTH & WELFARE BENEFITS PLAN plan

PACIFIC MARITIME FREIGHT HEALTH & WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	PACIFIC MARITIME FREIGHT HEALTH & WELFARE BENEFITS PLAN
Plan identification number	501

PACIFIC MARITIME FREIGHT HEALTH & WELFARE BENEFITS PLAN Benefits

401k Plan Type

Welfare Benefit

Plan Features/Benefits

Health (other than dental or vision)
Life insurance
Dental
Vision
Death benefits (include travel accident but not life insurance)
Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

PACIFIC MARITIME GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name: PACIFIC MARITIME GROUP, INC.

Employer identification number (EIN): 030471259

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PACIFIC MARITIME FREIGHT HEALTH & WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 ERIKA FELIX 2024-10-30
501 2021-01-01 KIMBERLY NORMAN 2022-08-16
501 2021-01-01 ERIKA FELIX 2023-11-16

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-01-01	ERIKA FELIX	2024-10-30
501	2021-01-01	KIMBERLY NORMAN	2022-08-16
501	2021-01-01	ERIKA FELIX	2023-11-16

Form 5500 Responses for PACIFIC MARITIME FREIGHT HEALTH & WELFARE BENEFITS PLAN

2023: PACIFIC MARITIME FREIGHT HEALTH & WELFARE BENEFITS 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 benefit arrangement – Insurance	Yes
2021: PACIFIC MARITIME FREIGHT HEALTH & WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	First time form 5500 has been submitted	Yes
2021-01-01	Submission has been amended	Yes
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

282238

Policy instance

Insurance contract or identification number	282238
Number of Individuals Covered	116
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $39,986
Total amount of fees paid to insurance company	USD $3,933
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $728,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

WP091

Policy instance

Insurance contract or identification number	WP091
Number of Individuals Covered	18
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $1,729
Total amount of fees paid to insurance company	USD $44
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to Carrier	USD $15,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

236222

Policy instance

Insurance contract or identification number	236222
Number of Individuals Covered	8
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $3,466
Total amount of fees paid to insurance company	USD $100
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $74,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

282238

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

WP091

Policy instance

Potentially related plans

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Company Name:	PACIFIC MARITIME GROUP, INC.
Employer identification number (EIN):	030471259
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services