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RJ ZAVORAL & SONS INC CAFETERIA PLAN 401k Plan overview

Plan NameRJ ZAVORAL & SONS INC CAFETERIA PLAN
Plan identification number 502

RJ ZAVORAL & SONS INC CAFETERIA PLAN Benefits

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

401k Sponsoring company profile

R. J. ZAVORAL & SONS, INC. has sponsored the creation of one or more 401k plans.

Company Name:R. J. ZAVORAL & SONS, INC.
Employer identification number (EIN):411356485
NAIC Classification:238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RJ ZAVORAL & SONS INC CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-06-01DAVID L ZAVORAL2023-12-04
5022021-06-01DAVID L ZAVORAL2022-11-17
5022020-06-01DAVID L ZAVORAL2021-12-23

Plan Statistics for RJ ZAVORAL & SONS INC CAFETERIA PLAN

401k plan membership statisitcs for RJ ZAVORAL & SONS INC CAFETERIA PLAN

Measure Date Value
2022: RJ ZAVORAL & SONS INC CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01109
Total number of active participants reported on line 7a of the Form 55002022-06-01103
Number of retired or separated participants receiving benefits2022-06-011
Total of all active and inactive participants2022-06-01104
2021: RJ ZAVORAL & SONS INC CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01118
Total number of active participants reported on line 7a of the Form 55002021-06-01112
Number of retired or separated participants receiving benefits2021-06-011
Total of all active and inactive participants2021-06-01113
2020: RJ ZAVORAL & SONS INC CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01109
Total number of active participants reported on line 7a of the Form 55002020-06-01116
Number of retired or separated participants receiving benefits2020-06-011
Total of all active and inactive participants2020-06-01117

Form 5500 Responses for RJ ZAVORAL & SONS INC CAFETERIA PLAN

2022: RJ ZAVORAL & SONS INC CAFETERIA PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan funding arrangement – General assets of the sponsorYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – General assets of the sponsorYes
2021: RJ ZAVORAL & SONS INC CAFETERIA PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan funding arrangement – General assets of the sponsorYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – General assets of the sponsorYes
2020: RJ ZAVORAL & SONS INC CAFETERIA PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01First time form 5500 has been submittedYes
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan funding arrangement – General assets of the sponsorYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number201205
Policy instance 1
Insurance contract or identification number201205
Number of Individuals Covered153
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $6,929
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $905,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,929
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJ0T36
Policy instance 2
Insurance contract or identification numberJ0T36
Number of Individuals Covered74
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $9,595
Total amount of fees paid to insurance companyUSD $396
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACC,CANCER,CRITICAL CARE,HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $66,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,132
Amount paid for insurance broker fees196
Additional information about fees paid to insurance brokerBONUSES AND NONMONETARY COMPENSATION
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number201205
Policy instance 1
Insurance contract or identification number201205
Number of Individuals Covered158
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $19,834
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $991,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,834
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJ0T36
Policy instance 2
Insurance contract or identification numberJ0T36
Number of Individuals Covered85
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $11,948
Total amount of fees paid to insurance companyUSD $62
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACC, CANCER,SPEC EVENT,HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $79,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,422
Amount paid for insurance broker fees21
Additional information about fees paid to insurance brokerBONUSES AND NONMONETARY COMPENSATION
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number201205
Policy instance 1
Insurance contract or identification number201205
Number of Individuals Covered161
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $17,239
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $861,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,239
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJ0T36
Policy instance 2
Insurance contract or identification numberJ0T36
Number of Individuals Covered49
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $10,465
Total amount of fees paid to insurance companyUSD $459
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACC, CANCER,SPEC EVENT,HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $66,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,454
Amount paid for insurance broker fees218
Additional information about fees paid to insurance brokerFEES, AWARDS, PRIZES, BONUSES
Insurance broker organization code?3

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