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PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN 401k Plan overview

Plan NamePETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN
Plan identification number 501

PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

PETER PAN SEAFOOD COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name:PETER PAN SEAFOOD COMPANY, LLC
Employer identification number (EIN):853882332
NAIC Classification:311710
NAIC Description:Seafood Product Preparation and Packaging

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01CHAR UMAYAM2024-01-02
5012021-04-01CHAR UMAYAM2022-10-21

Plan Statistics for PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN

401k plan membership statisitcs for PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN

Measure Date Value
2022: PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01179
Total number of active participants reported on line 7a of the Form 55002022-04-01201
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01201
Number of employers contributing to the scheme2022-04-010
2021: PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01110
Total number of active participants reported on line 7a of the Form 55002021-04-01179
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01179
Number of employers contributing to the scheme2021-04-010

Form 5500 Responses for PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN

2022: PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: PETER PAN SEAFOOD COMPANY, LLC HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberV7616
Policy instance 1
Insurance contract or identification numberV7616
Number of Individuals Covered40
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $3,391
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $14,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,024
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number875805G
Policy instance 2
Insurance contract or identification number875805G
Number of Individuals Covered101
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $7,510
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $59,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,510
Amount paid for insurance broker fees0
Insurance broker organization code?3
REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 )
Policy contract number65100000
Policy instance 3
Insurance contract or identification number65100000
Number of Individuals Covered306
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $82,851
Total amount of fees paid to insurance companyUSD $5,473
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,290,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $82,851
Amount paid for insurance broker fees5473
Additional information about fees paid to insurance brokerBONUS, NON-MONETARY COMPENSATION
Insurance broker organization code?3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberV7616
Policy instance 1
Insurance contract or identification numberV7616
Number of Individuals Covered24
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $1,419
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $8,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $955
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number875805G
Policy instance 2
Insurance contract or identification number875805G
Number of Individuals Covered83
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $6,065
Total amount of fees paid to insurance companyUSD $1,181
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $48,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,752
Amount paid for insurance broker fees319
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 )
Policy contract number65100000
Policy instance 3
Insurance contract or identification number65100000
Number of Individuals Covered208
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $82,424
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,482,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,315
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3342556
Policy instance 4
Insurance contract or identification number3342556
Number of Individuals Covered102
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $5,224
Total amount of fees paid to insurance companyUSD $240
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,702
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS

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