| Plan Name | BERRY & BERRY ACQUISITION DENTAL AND VISION PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | BERRY & BERRY ACQUISITION |
| Employer identification number (EIN): | 271488665 |
| NAIC Classification: | 444200 |
| NAIC Description: | Lawn and Garden Equipment and Supplies Stores |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2017-12-01 | HEATHER EDEN | 2019-09-09 |
| 2017: BERRY & BERRY ACQUISITION DENTAL AND VISION PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-12-01 | Type of plan entity | Single employer plan |
| 2017-12-01 | First time form 5500 has been submitted | Yes |
| 2017-12-01 | This submission is the final filing | Yes |
| 2017-12-01 | Plan funding arrangement – Insurance | Yes |
| 2017-12-01 | Plan benefit arrangement – Insurance | Yes |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-041329 |
| Policy instance | 1 |