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BLUEHAWK LLC GROUP HEALTH PLAN 401k Plan overview

Plan NameBLUEHAWK LLC GROUP HEALTH PLAN
Plan identification number 501

BLUEHAWK LLC GROUP HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

BLUEHAWK, LLC has sponsored the creation of one or more 401k plans.

Company Name:BLUEHAWK, LLC
Employer identification number (EIN):454133389
NAIC Classification:541600

Additional information about BLUEHAWK, LLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 2011-12-22
Company Identification Number: 603167293
Legal Registered Office Address: 10501 NE 38TH PL

KIRKLAND
United States of America (USA)
980337900

More information about BLUEHAWK, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUEHAWK LLC GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01STACEY HIGMAN2023-07-12
5012021-01-01STACEY HIGMAN2022-05-11
5012020-01-01STACEY BLAKNEY2021-06-04

Plan Statistics for BLUEHAWK LLC GROUP HEALTH PLAN

401k plan membership statisitcs for BLUEHAWK LLC GROUP HEALTH PLAN

Measure Date Value
2022: BLUEHAWK LLC GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01116
Total number of active participants reported on line 7a of the Form 55002022-01-01129
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01131
Number of employers contributing to the scheme2022-01-010
2021: BLUEHAWK LLC GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01118
Total number of active participants reported on line 7a of the Form 55002021-01-01135
Number of retired or separated participants receiving benefits2021-01-013
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01138
Number of employers contributing to the scheme2021-01-010
2020: BLUEHAWK LLC GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01136
Total number of active participants reported on line 7a of the Form 55002020-01-01118
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 participants2020-01-01118
Number of employers contributing to the scheme2020-01-010

Form 5500 Responses for BLUEHAWK LLC GROUP HEALTH PLAN

2022: BLUEHAWK LLC GROUP HEALTH PLAN 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: BLUEHAWK LLC GROUP HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: BLUEHAWK LLC GROUP HEALTH PLAN 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

PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number4016429
Policy instance 1
Insurance contract or identification number4016429
Number of Individuals Covered197
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $82,597
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 $1,651,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $82,597
Amount paid for insurance broker fees0
Insurance broker organization code?3
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number4016429
Policy instance 1
Insurance contract or identification number4016429
Number of Individuals Covered199
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $71,525
Total amount of fees paid to insurance companyUSD $13,832
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,430,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,525
Amount paid for insurance broker fees13832
Additional information about fees paid to insurance brokerPREFERRED PRODUCER PROGRAM
Insurance broker organization code?3
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number4016429
Policy instance 1
Insurance contract or identification number4016429
Number of Individuals Covered186
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $65,332
Total amount of fees paid to insurance companyUSD $9,631
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,306,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,332
Amount paid for insurance broker fees9631
Additional information about fees paid to insurance brokerPREFERRED PRODUCER PROGRAM
Insurance broker organization code?3

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