401k Plan data: BERTOLINO FOODS BENEFIT PLAN plan

BERTOLINO FOODS BENEFIT PLAN 401k Plan overview

Plan Name	BERTOLINO FOODS BENEFIT PLAN
Plan identification number	501

BERTOLINO FOODS BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Prepaid legal Death benefits (include travel accident but not life insurance) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

F.B. PACKING COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: F.B. PACKING COMPANY, INC.

Employer identification number (EIN): 043097088

NAIC Classification: 424990
NAIC Description: Other Miscellaneous Nondurable Goods Merchant Wholesalers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BERTOLINO FOODS BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-03-01 PATRICK PHELAN 2023-12-29

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-03-01	PATRICK PHELAN	2023-12-29

Plan Statistics for BERTOLINO FOODS BENEFIT PLAN

401k plan membership statisitcs for BERTOLINO FOODS BENEFIT PLAN

Measure Date Value
2022: BERTOLINO FOODS BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-03-01 130
Total number of active participants reported on line 7a of the Form 5500 2022-03-01 81
Number of retired or separated participants receiving benefits 2022-03-01 0
Number of other retired or separated participants entitled to future benefits 2022-03-01 0
Total of all active and inactive participants 2022-03-01 81
Number of employers contributing to the scheme 2022-03-01 0

Measure	Date	Value
2022: BERTOLINO FOODS BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-03-01	130
Total number of active participants reported on line 7a of the Form 5500	2022-03-01	81
Number of retired or separated participants receiving benefits	2022-03-01	0
Number of other retired or separated participants entitled to future benefits	2022-03-01	0
Total of all active and inactive participants	2022-03-01	81
Number of employers contributing to the scheme	2022-03-01	0

Form 5500 Responses for BERTOLINO FOODS BENEFIT PLAN

2022: BERTOLINO FOODS BENEFIT PLAN 2022 form 5500 responses
2022-03-01	Type of plan entity	Single employer plan
2022-03-01	First time form 5500 has been submitted	Yes
2022-03-01	Plan funding arrangement – Insurance	Yes
2022-03-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-03-01	Plan benefit arrangement – Insurance	Yes
2022-03-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

41343

Policy instance

Insurance contract or identification number	41343
Number of Individuals Covered	124
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $30,624
Total amount of fees paid to insurance company	USD $8,218
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $976,955
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $30,624
Amount paid for insurance broker fees	8218
Additional information about fees paid to insurance broker	OHTER COMMISSION
Insurance broker organization code?	3

DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )

Policy contract number

15623

Policy instance

Insurance contract or identification number	15623
Number of Individuals Covered	124
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $3,281
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $71,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,281
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10324531001

Policy instance

Insurance contract or identification number	10324531001
Number of Individuals Covered	74
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $1,711
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $685
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E5786264

Policy instance

Insurance contract or identification number	E5786264
Number of Individuals Covered	89
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $42,413
Total amount of fees paid to insurance company	USD $21,568
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $63,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,574
Amount paid for insurance broker fees	547
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

161579

Policy instance

Insurance contract or identification number	161579
Number of Individuals Covered	24
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $2,188
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	LEGAL
Welfare Benefit Premiums Paid to Carrier	USD $4,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,117
Insurance broker organization code?	4
Amount paid for insurance broker fees	0

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Company Name:	F.B. PACKING COMPANY, INC.
Employer identification number (EIN):	043097088
NAIC Classification:	424990
NAIC Description:	Other Miscellaneous Nondurable Goods Merchant Wholesalers