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EMPLOYEE MEDICAL AND DENTAL PLAN 401k Plan overview

Plan NameEMPLOYEE MEDICAL AND DENTAL PLAN
Plan identification number 507

EMPLOYEE MEDICAL AND DENTAL PLAN Benefits

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

401k Sponsoring company profile

BG-IC, LLC has sponsored the creation of one or more 401k plans.

Company Name:BG-IC, LLC
Employer identification number (EIN):161758404
NAIC Classification:531310

Additional information about BG-IC, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2015-01-02
Company Identification Number: 0802127692
Legal Registered Office Address: 1 BEACON ST FL 24

BOSTON
United States of America (USA)
02108

More information about BG-IC, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE MEDICAL AND DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072022-01-01SUSAN SHEEHAN2023-05-09
5072021-01-01JENN LICCIARDI2022-07-15
5072020-01-01JENN LICCIARDI2021-06-21
5072019-01-01JENNIFER LICCIARDI2020-05-19
5072018-01-01

Plan Statistics for EMPLOYEE MEDICAL AND DENTAL PLAN

401k plan membership statisitcs for EMPLOYEE MEDICAL AND DENTAL PLAN

Measure Date Value
2022: EMPLOYEE MEDICAL AND DENTAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01761
Total number of active participants reported on line 7a of the Form 55002022-01-01794
Number of retired or separated participants receiving benefits2022-01-018
Number of other retired or separated participants entitled to future benefits2022-01-0147
Total of all active and inactive participants2022-01-01849
Number of employers contributing to the scheme2022-01-010
2021: EMPLOYEE MEDICAL AND DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01715
Total number of active participants reported on line 7a of the Form 55002021-01-01761
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-0163
Total of all active and inactive participants2021-01-01825
Number of employers contributing to the scheme2021-01-010
2020: EMPLOYEE MEDICAL AND DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01708
Total number of active participants reported on line 7a of the Form 55002020-01-01715
Number of retired or separated participants receiving benefits2020-01-019
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01724
Number of employers contributing to the scheme2020-01-010
2019: EMPLOYEE MEDICAL AND DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01662
Total number of active participants reported on line 7a of the Form 55002019-01-01692
Number of retired or separated participants receiving benefits2019-01-0116
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01708
Number of employers contributing to the scheme2019-01-010
2018: EMPLOYEE MEDICAL AND DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01687
Total number of active participants reported on line 7a of the Form 55002018-01-01647
Number of retired or separated participants receiving benefits2018-01-0115
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01662
Number of employers contributing to the scheme2018-01-010

Form 5500 Responses for EMPLOYEE MEDICAL AND DENTAL PLAN

2022: EMPLOYEE MEDICAL AND DENTAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: EMPLOYEE MEDICAL AND DENTAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: EMPLOYEE MEDICAL AND DENTAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: EMPLOYEE MEDICAL AND DENTAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: EMPLOYEE MEDICAL AND DENTAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number760560
Policy instance 6
Insurance contract or identification number760560
Number of Individuals Covered1078
Insurance policy start date2022-03-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,716
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,716
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417337 0001
Policy instance 5
Insurance contract or identification number417337 0001
Number of Individuals Covered771
Insurance policy start date2022-01-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $315
Total amount of fees paid to insurance companyUSD $690
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $39,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $315
Amount paid for insurance broker fees690
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
METROPOLITAN GENERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 39950 )
Policy contract number9903156
Policy instance 4
Insurance contract or identification number9903156
Number of Individuals Covered71
Insurance policy start date2022-10-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $439
Total amount of fees paid to insurance companyUSD $73
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $439
Amount paid for insurance broker fees73
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 )
Policy contract number9903156
Policy instance 3
Insurance contract or identification number9903156
Number of Individuals Covered68
Insurance policy start date2022-01-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $1,340
Total amount of fees paid to insurance companyUSD $314
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $7,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,340
Amount paid for insurance broker fees314
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL630219
Policy instance 2
Insurance contract or identification numberABL630219
Number of Individuals Covered794
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $353
Total amount of fees paid to insurance companyUSD $30
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $2,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $353
Amount paid for insurance broker fees30
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98814001001
Policy instance 1
Insurance contract or identification number98814001001
Number of Individuals Covered1159
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,579
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,579
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417337
Policy instance 3
Insurance contract or identification number417337
Number of Individuals Covered761
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $13,500
Total amount of fees paid to insurance companyUSD $7,472
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $426,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,500
Amount paid for insurance broker fees7472
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL630219
Policy instance 2
Insurance contract or identification numberABL630219
Number of Individuals Covered761
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $28
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees28
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98814001001
Policy instance 1
Insurance contract or identification number98814001001
Number of Individuals Covered958
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,848
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,848
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417337
Policy instance 3
Insurance contract or identification number417337
Number of Individuals Covered1508
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,483
Total amount of fees paid to insurance companyUSD $8,410
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $465,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,483
Amount paid for insurance broker fees8410
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL630219
Policy instance 2
Insurance contract or identification numberABL630219
Number of Individuals Covered715
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $28
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees28
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98814001001
Policy instance 1
Insurance contract or identification number98814001001
Number of Individuals Covered875
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,537
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,537
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417337
Policy instance 3
Insurance contract or identification number417337
Number of Individuals Covered1340
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $13,017
Total amount of fees paid to insurance companyUSD $2,767
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $403,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,017
Amount paid for insurance broker fees2767
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL630219
Policy instance 2
Insurance contract or identification numberABL630219
Number of Individuals Covered1340
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $633
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $4,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $633
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98814001001
Policy instance 1
Insurance contract or identification number98814001001
Number of Individuals Covered831
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,781
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,404
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417337
Policy instance 3
Insurance contract or identification number417337
Number of Individuals Covered645
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $13,965
Total amount of fees paid to insurance companyUSD $2,506
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $445,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,965
Amount paid for insurance broker fees2506
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberABL630219
Policy instance 2
Insurance contract or identification numberABL630219
Number of Individuals Covered647
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $109
Total amount of fees paid to insurance companyUSD $13
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $109
Amount paid for insurance broker fees13
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98814001001
Policy instance 1
Insurance contract or identification number98814001001
Number of Individuals Covered769
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,732
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,729
Amount paid for insurance broker fees0
Insurance broker organization code?3

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