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HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 401k Plan overview

Plan NameHEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN
Plan identification number 501

HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

HEART OF AMERICA BEVERAGE COMPANY, LL has sponsored the creation of one or more 401k plans.

Company Name:HEART OF AMERICA BEVERAGE COMPANY, LL
Employer identification number (EIN):431933310
NAIC Classification:424800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01HARWOOD FERGUSON2023-07-31
5012021-01-01HARWOOD FERGUSON2022-07-05
5012020-01-01HARWOOD FERGUSON2021-09-13
5012019-01-01HARWOOD FERGUSON2020-07-27
5012018-01-01HARWOOD FERGUSON2019-07-26
5012017-01-01
5012016-01-01

Plan Statistics for HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN

401k plan membership statisitcs for HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN

Measure Date Value
2022: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01127
Total number of active participants reported on line 7a of the Form 55002022-01-01119
Total of all active and inactive participants2022-01-01119
2021: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01113
Total number of active participants reported on line 7a of the Form 55002021-01-01127
Total of all active and inactive participants2021-01-01127
2020: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01108
Total number of active participants reported on line 7a of the Form 55002020-01-01113
Total of all active and inactive participants2020-01-01113
2019: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01111
Total number of active participants reported on line 7a of the Form 55002019-01-01108
Total of all active and inactive participants2019-01-01108
2018: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01114
Total number of active participants reported on line 7a of the Form 55002018-01-01111
Total of all active and inactive participants2018-01-01111
2017: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01134
Total number of active participants reported on line 7a of the Form 55002017-01-01114
Total of all active and inactive participants2017-01-01114
2016: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01106
Total number of active participants reported on line 7a of the Form 55002016-01-01134
Total of all active and inactive participants2016-01-01134

Form 5500 Responses for HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN

2022: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: HEART OF AMERICA BEVERAGE COMPANY LLC EMPLOYEE HEALTH CARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )
Policy contract numberGL-22749
Policy instance 2
Insurance contract or identification numberGL-22749
Number of Individuals Covered119
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $22,285
Total amount of fees paid to insurance companyUSD $33,466
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,285
Amount paid for insurance broker fees22219
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?5
GREENWICH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22322 )
Policy contract numberSXTG1080-22
Policy instance 1
Insurance contract or identification numberSXTG1080-22
Number of Individuals Covered119
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
Welfare Benefit Premiums Paid to CarrierUSD $200,533
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )
Policy contract numberGL-22749
Policy instance 2
Insurance contract or identification numberGL-22749
Number of Individuals Covered127
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $21,096
Total amount of fees paid to insurance companyUSD $24,376
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,096
Amount paid for insurance broker fees21717
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?5
GREENWICH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22322 )
Policy contract numberSXTG1080-21
Policy instance 1
Insurance contract or identification numberSXTG1080-21
Number of Individuals Covered127
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $189,863
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )
Policy contract numberGL-22749
Policy instance 2
Insurance contract or identification numberGL-22749
Number of Individuals Covered113
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $20,288
Total amount of fees paid to insurance companyUSD $30,739
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,288
Amount paid for insurance broker fees20068
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?5
GREENWICH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22322 )
Policy contract numberSXTG1080-20
Policy instance 1
Insurance contract or identification numberSXTG1080-20
Number of Individuals Covered113
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $182,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )
Policy contract numberGL-22749
Policy instance 2
Insurance contract or identification numberGL-22749
Number of Individuals Covered108
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $19,225
Total amount of fees paid to insurance companyUSD $23,269
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,225
Amount paid for insurance broker fees20220
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?5
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract numberANTX-44062
Policy instance 1
Insurance contract or identification numberANTX-44062
Number of Individuals Covered108
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $173,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )
Policy contract numberGL-22749
Policy instance 2
Insurance contract or identification numberGL-22749
Number of Individuals Covered114
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $20,672
Total amount of fees paid to insurance companyUSD $26,991
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,672
Amount paid for insurance broker fees21555
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?5
Insurance broker nameMEDTRAK SERVICES
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract numberANTX-44062
Policy instance 1
Insurance contract or identification numberANTX-44062
Number of Individuals Covered114
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $186,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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