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SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN 401k Plan overview

Plan NameSHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN
Plan identification number 501

SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

SHOTTENKIRK AUTOMOTIVE GROUP has sponsored the creation of one or more 401k plans.

Company Name:SHOTTENKIRK AUTOMOTIVE GROUP
Employer identification number (EIN):465048533
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-07-01CAROL BONE2021-11-18
5012019-07-01CAROL BONE2021-07-27

Plan Statistics for SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN

401k plan membership statisitcs for SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN

Measure Date Value
2020: SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01107
Total number of active participants reported on line 7a of the Form 55002020-07-01112
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01112
Number of employers contributing to the scheme2020-07-010
2019: SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01200
Total number of active participants reported on line 7a of the Form 55002019-07-01107
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01107
Number of employers contributing to the scheme2019-07-010

Form 5500 Responses for SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN

2020: SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: SHOTTENKIRK AUTOMOTIVE GROUP WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGB0139
Policy instance 1
Insurance contract or identification numberGB0139
Number of Individuals Covered209
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $58,879
Total amount of fees paid to insurance companyUSD $998
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,212,589
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,295
Amount paid for insurance broker fees998
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberG1C832
Policy instance 2
Insurance contract or identification numberG1C832
Number of Individuals Covered34
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $3,970
Total amount of fees paid to insurance companyUSD $410
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $26,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,007
Amount paid for insurance broker fees410
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number562925
Policy instance 3
Insurance contract or identification number562925
Number of Individuals Covered59
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $14,669
Total amount of fees paid to insurance companyUSD $839
Other welfare benefits providedACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $20,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,451
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberG1C832
Policy instance 1
Insurance contract or identification numberG1C832
Number of Individuals Covered31
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $4,068
Total amount of fees paid to insurance companyUSD $960
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $28,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number562925
Policy instance 2
Insurance contract or identification number562925
Number of Individuals Covered71
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $13,522
Total amount of fees paid to insurance companyUSD $467
Other welfare benefits providedACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $23,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGB0139
Policy instance 3
Insurance contract or identification numberGB0139
Number of Individuals Covered195
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $51,801
Total amount of fees paid to insurance companyUSD $2,590
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,071,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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