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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA 401k Plan overview

Plan NameBLUE CROSS BLUE SHIELD OF SOUTH CAROLINA
Plan identification number 502

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

MSI-VIKING GAGE, LLC has sponsored the creation of one or more 401k plans.

Company Name:MSI-VIKING GAGE, LLC
Employer identification number (EIN):223851031
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-10-01JANNAH KELLEY2023-03-23

Plan Statistics for BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA

401k plan membership statisitcs for BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA

Measure Date Value
2021: BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA 2021 401k membership
Total participants, beginning-of-year2021-10-01100
Total number of active participants reported on line 7a of the Form 55002021-10-01122
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01122
Number of employers contributing to the scheme2021-10-010

Form 5500 Responses for BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA

2021: BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01First time form 5500 has been submittedYes
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number66-16897
Policy instance 1
Insurance contract or identification number66-16897
Number of Individuals Covered122
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $46,875
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,875
Amount paid for insurance broker fees0
Insurance broker organization code?3

Potentially related plans

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