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CANTON REGIONAL CHAMBER HEALTH FUND 401k Plan overview

Plan NameCANTON REGIONAL CHAMBER HEALTH FUND
Plan identification number 501

CANTON REGIONAL CHAMBER HEALTH FUND 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.

401k Sponsoring company profile

BLOOM'S PRINTING, INC. has sponsored the creation of one or more 401k plans.

Company Name:BLOOM'S PRINTING, INC.
Employer identification number (EIN):341789443
NAIC Classification:323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CANTON REGIONAL CHAMBER HEALTH FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-01-01 RICHARD BLOOM, JR.2021-10-12

Plan Statistics for CANTON REGIONAL CHAMBER HEALTH FUND

401k plan membership statisitcs for CANTON REGIONAL CHAMBER HEALTH FUND

Measure Date Value
2020: CANTON REGIONAL CHAMBER HEALTH FUND 2020 401k membership
Total participants, beginning-of-year2020-01-010
Total number of active participants reported on line 7a of the Form 55002020-01-014
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-014

Financial Data on CANTON REGIONAL CHAMBER HEALTH FUND

Measure Date Value
2020 : CANTON REGIONAL CHAMBER HEALTH FUND 2020 401k financial data
Transfers to/from the plan2020-12-31$4
Total plan liabilities at end of year2020-12-31$3,211
Total income from all sources2020-12-31$30,995
Expenses. Total of all expenses incurred2020-12-31$28,515
Benefits paid (including direct rollovers)2020-12-31$485
Total plan assets at end of year2020-12-31$5,695
Total plan assets at beginning of year2020-12-31$0
Value of fidelity bond covering the plan2020-12-31$1,000,000
Total contributions received or receivable from participants2020-12-31$130
Expenses. Other expenses not covered elsewhere2020-12-31$23
Net income (gross income less expenses)2020-12-31$2,480
Net plan assets at end of year (total assets less liabilities)2020-12-31$2,484
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$0
Total contributions received or receivable from employer(s)2020-12-31$30,865
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$28,007

Form 5500 Responses for CANTON REGIONAL CHAMBER HEALTH FUND

2020: CANTON REGIONAL CHAMBER HEALTH FUND 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 funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )
Policy contract numberHF865
Policy instance 1
Insurance contract or identification numberHF865
Number of Individuals Covered4
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $540
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $540
Insurance broker organization code?3

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