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FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN 401k Plan overview

Plan NameFORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN
Plan identification number 502

FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

FORBES BROS. USA, INC. has sponsored the creation of one or more 401k plans.

Company Name:FORBES BROS. USA, INC.
Employer identification number (EIN):473008794
NAIC Classification:221100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-07-01SHAWN CHAUDHARY2023-01-18
5022020-07-01COREY PAPP2022-01-04
5022020-07-01SHAWN CHAUDHARY2023-01-18

Plan Statistics for FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN

401k plan membership statisitcs for FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN

Measure Date Value
2021: FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01115
Total number of active participants reported on line 7a of the Form 55002021-07-01211
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01211
2020: FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01178
Total number of active participants reported on line 7a of the Form 55002020-07-010
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-010

Form 5500 Responses for FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN

2021: FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: FORBES BROS. USA, INC DENTAL, LIFE, STD & LTD PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01First time form 5500 has been submittedYes
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingYes
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number932318
Policy instance 1
Insurance contract or identification number932318
Number of Individuals Covered234
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $31,660
Total amount of fees paid to insurance companyUSD $7,061
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, AD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $280,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,660
Amount paid for insurance broker fees6024
Additional information about fees paid to insurance brokerCOMMISSIONS AND FEES
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number932318
Policy instance 1
Insurance contract or identification number932318
Number of Individuals Covered256
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $20,977
Total amount of fees paid to insurance companyUSD $6,376
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, AD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $191,863
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,977
Amount paid for insurance broker fees5078
Additional information about fees paid to insurance brokerCOMMISSIONS AND FEES
Insurance broker organization code?3

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