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COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN 401k Plan overview

Plan NameCOURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN
Plan identification number 502

COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • Vision

401k Sponsoring company profile

COURTESY FORD, INC. has sponsored the creation of one or more 401k plans.

Company Name:COURTESY FORD, INC.
Employer identification number (EIN):580943526
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-12-01ASHLEY KELLY2024-08-30
5022021-12-01ASHLEY KELLY2024-08-30
5022020-12-01ASHLEY KELLY2024-08-30
5022019-12-01ASHLEY KELLY2024-08-30

Form 5500 Responses for COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN

2022: COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN 2022 form 5500 responses
2022-12-01Type of plan entitySingle employer plan
2022-12-01This submission is the final filingYes
2022-12-01Plan funding arrangement – InsuranceYes
2022-12-01Plan benefit arrangement – InsuranceYes
2021: COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – InsuranceYes
2020: COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – InsuranceYes
2019: COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01First time form 5500 has been submittedYes
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan 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 numberGA9868
Policy instance 1
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA9868
Policy instance 1
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA9868
Policy instance 1
Insurance contract or identification numberGA9868
Number of Individuals Covered251
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $11,551
Total amount of fees paid to insurance companyUSD $491
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $118,931
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 numberGA9868
Policy instance 1
Insurance contract or identification numberGA9868
Number of Individuals Covered221
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $12,221
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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