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BOCCHI LABORATORIES MEDICAL PLAN 401k Plan overview

Plan NameBOCCHI LABORATORIES MEDICAL PLAN
Plan identification number 504

BOCCHI LABORATORIES MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • 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.
  • 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

SHADOW HOLDINGS, LLC DBA BRIGHT INNOVATION LABS has sponsored the creation of one or more 401k plans.

Company Name:SHADOW HOLDINGS, LLC DBA BRIGHT INNOVATION LABS
Employer identification number (EIN):261455829
NAIC Classification:424210
NAIC Description:Drugs and Druggists' Sundries Merchant Wholesalers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOCCHI LABORATORIES MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-06-01KYLE CLINE2023-10-12
5042018-06-01MICHAEL HUGHES2020-03-10
5042016-06-01

Plan Statistics for BOCCHI LABORATORIES MEDICAL PLAN

401k plan membership statisitcs for BOCCHI LABORATORIES MEDICAL PLAN

Measure Date Value
2022: BOCCHI LABORATORIES MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01100
Total number of active participants reported on line 7a of the Form 55002022-06-01100
Number of retired or separated participants receiving benefits2022-06-010
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-01100
Number of employers contributing to the scheme2022-06-010
2018: BOCCHI LABORATORIES MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01100
Total number of active participants reported on line 7a of the Form 55002018-06-0153
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-0153
Number of employers contributing to the scheme2018-06-010
2016: BOCCHI LABORATORIES MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01100
Total number of active participants reported on line 7a of the Form 55002016-06-0148
Number of retired or separated participants receiving benefits2016-06-010
Number of other retired or separated participants entitled to future benefits2016-06-010
Total of all active and inactive participants2016-06-0148

Form 5500 Responses for BOCCHI LABORATORIES MEDICAL PLAN

2022: BOCCHI LABORATORIES MEDICAL PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – InsuranceYes
2018: BOCCHI LABORATORIES MEDICAL PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2016: BOCCHI LABORATORIES MEDICAL PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01First time form 5500 has been submittedYes
2016-06-01Submission has been amendedNo
2016-06-01This submission is the final filingNo
2016-06-01This return/report is a short plan year return/report (less than 12 months)No
2016-06-01Plan is a collectively bargained planNo
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number226397
Policy instance 1
Insurance contract or identification number226397
Number of Individuals Covered100
Insurance policy start date2022-06-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number226397
Policy instance 1
Insurance contract or identification number226397
Number of Individuals Covered124
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $23,636
Total amount of fees paid to insurance companyUSD $2,612
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $630,216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,636
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS

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