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DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 401k Plan overview

Plan NameDENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC.
Plan identification number 504

DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

BOSCOV'S, INC. has sponsored the creation of one or more 401k plans.

Company Name:BOSCOV'S, INC.
Employer identification number (EIN):231571589
NAIC Classification:448140
NAIC Description:Family Clothing Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042021-01-01MICHELLE L. DUPELL2022-08-18
5042020-01-01DIETER F. CZERNY2021-08-03
5042019-01-01DIETER F. CZERNY2020-05-28
5042018-01-01TONI MILLER
5042017-01-01TONI MILLER
5042016-01-01TONI MILLER
5042015-01-01TONI MILER
5042014-01-01TONI MILLER
5042013-01-01TONI MILLER
5042012-01-01TONI MILLER
5042011-01-01TONI MILLER
5042009-01-01TONI MILLER

Plan Statistics for DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC.

401k plan membership statisitcs for DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC.

Measure Date Value
2021: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2021 401k membership
Total participants, beginning-of-year2021-01-012,674
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-010
2020: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2020 401k membership
Total participants, beginning-of-year2020-01-013,445
Total number of active participants reported on line 7a of the Form 55002020-01-012,596
Number of retired or separated participants receiving benefits2020-01-0159
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-012,655
2019: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2019 401k membership
Total participants, beginning-of-year2019-01-013,389
Total number of active participants reported on line 7a of the Form 55002019-01-013,265
Number of retired or separated participants receiving benefits2019-01-0123
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-013,288
2018: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2018 401k membership
Total participants, beginning-of-year2018-01-013,312
Total number of active participants reported on line 7a of the Form 55002018-01-013,325
Total of all active and inactive participants2018-01-013,325
2017: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2017 401k membership
Total participants, beginning-of-year2017-01-013,286
Total number of active participants reported on line 7a of the Form 55002017-01-013,312
Total of all active and inactive participants2017-01-013,312
Total participants2017-01-013,312
2016: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2016 401k membership
Total participants, beginning-of-year2016-01-013,247
Total number of active participants reported on line 7a of the Form 55002016-01-013,286
Total of all active and inactive participants2016-01-013,286
Total participants2016-01-013,286
2015: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2015 401k membership
Total participants, beginning-of-year2015-01-013,169
Total number of active participants reported on line 7a of the Form 55002015-01-013,247
Total of all active and inactive participants2015-01-013,247
Total participants2015-01-013,247
2014: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2014 401k membership
Total participants, beginning-of-year2014-01-013,042
Total number of active participants reported on line 7a of the Form 55002014-01-013,169
Total of all active and inactive participants2014-01-013,169
Total participants2014-01-013,169
2013: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2013 401k membership
Total participants, beginning-of-year2013-01-013,036
Total number of active participants reported on line 7a of the Form 55002013-01-013,042
Total of all active and inactive participants2013-01-013,042
Total participants2013-01-013,042
2012: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-013,109
Total number of active participants reported on line 7a of the Form 55002012-01-013,036
Total of all active and inactive participants2012-01-013,036
Total participants2012-01-013,036
2011: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2011 401k membership
Total participants, beginning-of-year2011-01-013,241
Total number of active participants reported on line 7a of the Form 55002011-01-013,109
Total of all active and inactive participants2011-01-013,109
Total participants2011-01-013,109
2009: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2009 401k membership
Total participants, beginning-of-year2009-01-013,559
Total number of active participants reported on line 7a of the Form 55002009-01-013,417
Total of all active and inactive participants2009-01-013,417
Total participants2009-01-013,417

Form 5500 Responses for DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC.

2021: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 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: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: DENTAL PLAN FOR THE EMPLOYEES OF BOSCOV'S, INC. 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number232502
Policy instance 1
Insurance contract or identification number232502
Number of Individuals Covered3593
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $22,572
Total amount of fees paid to insurance companyUSD $11,404
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $770,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,572
Amount paid for insurance broker fees34
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number07301
Policy instance 1
Insurance contract or identification number07301
Number of Individuals Covered3383
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $29,750
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $893,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,750
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number07301
Policy instance 1
Insurance contract or identification number07301
Number of Individuals Covered3301
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $32,458
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $979,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,741
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number07301
Policy instance 1
Insurance contract or identification number07301
Number of Individuals Covered3325
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $32,182
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $985,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,182
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number07301
Policy instance 1
Insurance contract or identification number07301
Number of Individuals Covered3312
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $32,206
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $975,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,206
Insurance broker organization code?3
Insurance broker nameKINLOCH CONSULTING GROUP, INC.
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number07301
Policy instance 1
Insurance contract or identification number07301
Number of Individuals Covered3247
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $30,687
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $941,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,687
Insurance broker organization code?3
Insurance broker nameKINLOCH CONSULTING GROUP, INC.
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number07301
Policy instance 1
Insurance contract or identification number07301
Number of Individuals Covered3169
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $30,132
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $926,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,132
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameKINLOCH CONSULTING GROUP, INC.
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number07301
Policy instance 1
Insurance contract or identification number07301
Number of Individuals Covered3042
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $28,688
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $909,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,688
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameKINLOCH CONSULTING GROUP, INC.
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPAO7301
Policy instance 1
Insurance contract or identification numberPAO7301
Number of Individuals Covered3036
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $29,473
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $938,421
Commission paid to Insurance BrokerUSD $29,473
Insurance broker organization code?3
Insurance broker nameKINLOCH CONSULTING GROUP, INC.
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPAO7301
Policy instance 1
Insurance contract or identification numberPAO7301
Number of Individuals Covered3109
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $17,818
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,016,172
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract numberPAO7301
Policy instance 1
Insurance contract or identification numberPAO7301
Number of Individuals Covered3241
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $31,755
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,026,659
Commission paid to Insurance BrokerUSD $31,755
Insurance broker organization code?3
Insurance broker nameKINLOCH CONSUTLING GROUP, INC.

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