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| Plan Name | BRAVO SPORTS WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BRAVO SPORTS |
| Employer identification number (EIN): | 330223439 |
| NAIC Classification: | 423910 |
| NAIC Description: | Sporting and Recreational Goods and Supplies Merchant Wholesalers |
Additional information about BRAVO SPORTS
| Jurisdiction of Incorporation: | California Department of State |
| Incorporation Date: | 1987-03-10 |
| Company Identification Number: | C1401475 |
| Legal Registered Office Address: |
12801 Carmenita Road Santa Fe Springs United States of America (USA) 90670 |
More information about BRAVO SPORTS
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-11-01 | MICHELLE OLIVA | 2019-04-23 | ||
| 501 | 2017-11-01 | MICHELLE OLIVA | 2022-11-08 | ||
| 501 | 2016-11-01 |
| Measure | Date | Value |
|---|---|---|
| 2017: BRAVO SPORTS WELFARE BENEFIT PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-11-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 104 |
| Number of retired or separated participants receiving benefits | 2017-11-01 | 94 |
| Number of other retired or separated participants entitled to future benefits | 2017-11-01 | 94 |
| Total of all active and inactive participants | 2017-11-01 | 292 |
| Number of employers contributing to the scheme | 2017-11-01 | 0 |
| 2016: BRAVO SPORTS WELFARE BENEFIT PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-11-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 107 |
| Number of retired or separated participants receiving benefits | 2016-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-11-01 | 0 |
| Total of all active and inactive participants | 2016-11-01 | 107 |
| 2017: BRAVO SPORTS WELFARE BENEFIT PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-11-01 | Type of plan entity | Single employer plan |
| 2017-11-01 | Submission has been amended | Yes |
| 2017-11-01 | Plan funding arrangement – Insurance | Yes |
| 2017-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: BRAVO SPORTS WELFARE BENEFIT PLAN 2016 form 5500 responses | ||
| 2016-11-01 | Type of plan entity | Single employer plan |
| 2016-11-01 | First time form 5500 has been submitted | Yes |
| 2016-11-01 | Plan funding arrangement – Insurance | Yes |
| 2016-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 153806 | ||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |||||||||||||||||||||||||||||||||||||||||
| Policy contract number | ACA2689941 | ||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 858405G | ||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||
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