401k Plan data: CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL plan

CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL 401k Plan overview

Plan Name	CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL
Plan identification number	502

CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental Vision

401k Sponsoring company profile

CLASS ACT MANAGEMENT has sponsored the creation of one or more 401k plans.

Company Name: CLASS ACT MANAGEMENT

Employer identification number (EIN): 431677866

NAIC Classification: 722513
NAIC Description: Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2020-01-01 PAM MCNEIL 2021-06-24
502 2019-01-01 PAMELA MCNEIL 2020-04-03

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2020-01-01	PAM MCNEIL	2021-06-24
502	2019-01-01	PAMELA MCNEIL	2020-04-03

Plan Statistics for CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL

401k plan membership statisitcs for CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL

Measure Date Value
2020: CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL 2020 401k membership
Total participants, beginning-of-year 2020-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
Number of employers contributing to the scheme 2020-01-01 0
2019: CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL 2019 401k membership
Total participants, beginning-of-year 2019-01-01 114
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 112
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 112
Number of employers contributing to the scheme 2019-01-01 0

Measure	Date	Value
2020: CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL 2020 401k membership
Total participants, beginning-of-year	2020-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
Number of employers contributing to the scheme	2020-01-01	0
2019: CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL 2019 401k membership
Total participants, beginning-of-year	2019-01-01	114
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	112
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	112
Number of employers contributing to the scheme	2019-01-01	0

Form 5500 Responses for CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL

2020: CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	This submission is the final filing	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: CLASS ACT MANAGEMENT DBA MCDONALDS DENTAL 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	First time form 5500 has been submitted	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

568150

Policy instance

Insurance contract or identification number	568150
Number of Individuals Covered	129
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $7,443
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $61,187
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,443
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )

Policy contract number

81202213

Policy instance

Insurance contract or identification number	81202213
Number of Individuals Covered	124
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $6,142
Total amount of fees paid to insurance company	USD $81
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $64,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,142
Amount paid for insurance broker fees	81
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

ADVANTICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12278 )

Policy contract number

17031601

Policy instance

Insurance contract or identification number	17031601
Number of Individuals Covered	122
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $874
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,623
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $874
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	CLASS ACT MANAGEMENT
Employer identification number (EIN):	431677866
NAIC Classification:	722513
NAIC Description:	Limited-Service Restaurants