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IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM 401k Plan overview

Plan NameIMPACT FITNESS EMPLOYEE BENEFIT PROGRAM
Plan identification number 501

IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

BCDI GREAT LAKES HOLDING, INC. has sponsored the creation of one or more 401k plans.

Company Name:BCDI GREAT LAKES HOLDING, INC.
Employer identification number (EIN):274939300
NAIC Classification:551112
NAIC Description:Offices of Other Holding Companies

Form 5500 Filing Information

Submission information for form 5500 for 401k plan IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012021-01-01
5012020-01-01

Plan Statistics for IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM

401k plan membership statisitcs for IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM

Measure Date Value
2022: IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM 2022 401k membership
Total participants, beginning-of-year2022-01-01120
Total number of active participants reported on line 7a of the Form 55002022-01-01126
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01126
2021: IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM 2021 401k membership
Total participants, beginning-of-year2021-01-01125
Total number of active participants reported on line 7a of the Form 55002021-01-01118
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01120
2020: IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM 2020 401k membership
Total participants, beginning-of-year2020-01-01140
Total number of active participants reported on line 7a of the Form 55002020-01-01124
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01125

Form 5500 Responses for IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM

2022: IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: IMPACT FITNESS EMPLOYEE BENEFIT PROGRAM 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00569367
Policy instance 1
Insurance contract or identification number00569367
Number of Individuals Covered126
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $11,201
Total amount of fees paid to insurance companyUSD $4,932
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, EAP
Welfare Benefit Premiums Paid to CarrierUSD $87,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,201
Amount paid for insurance broker fees4932
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number288324
Policy instance 2
Insurance contract or identification number288324
Number of Individuals Covered41
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,842
Total amount of fees paid to insurance companyUSD $396
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,842
Insurance broker organization code?3
Amount paid for insurance broker fees396
Additional information about fees paid to insurance brokerFEES AND OTHER COMMISSIONS
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number288324
Policy instance 3
Insurance contract or identification number288324
Number of Individuals Covered100
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $12,054
Total amount of fees paid to insurance companyUSD $735
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,054
Insurance broker organization code?3
Amount paid for insurance broker fees735
Additional information about fees paid to insurance brokerFEES AND OTHER COMMISSIONS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00569367
Policy instance 1
Insurance contract or identification number00569367
Number of Individuals Covered118
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,610
Total amount of fees paid to insurance companyUSD $1,580
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,610
Amount paid for insurance broker fees1580
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, EAP
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number288324
Policy instance 2
Insurance contract or identification number288324
Number of Individuals Covered50
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,376
Total amount of fees paid to insurance companyUSD $40
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,376
Insurance broker organization code?3
Amount paid for insurance broker fees40
Additional information about fees paid to insurance brokerFEES AND OTHER COMMISSIONS
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number288324
Policy instance 3
Insurance contract or identification number288324
Number of Individuals Covered98
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,881
Total amount of fees paid to insurance companyUSD $57
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,881
Insurance broker organization code?3
Amount paid for insurance broker fees57
Additional information about fees paid to insurance brokerFEES AND OTHER COMMISSIONS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00569367
Policy instance 1
Insurance contract or identification number00569367
Number of Individuals Covered140
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,677
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,677
Insurance broker organization code?3

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