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BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 401k Plan overview

Plan NameBLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN
Plan identification number 501

BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

BLACK & MCDONALD, INC. has sponsored the creation of one or more 401k plans.

Company Name:BLACK & MCDONALD, INC.
Employer identification number (EIN):522021787
NAIC Classification:238210
NAIC Description:Electrical Contractors and Other Wiring Installation Contractors

Additional information about BLACK & MCDONALD, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1977-08-24
Company Identification Number: 543755
Legal Registered Office Address: 766 HUDSON AVENUE

SARASOTA

33577

More information about BLACK & MCDONALD, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01BRYAN EITZMANN BRYAN EITZMANN2019-07-25
5012017-01-01BRYAN EITZMANN BRYAN EITZMANN2018-07-25
5012016-01-01KIMBERLY HENRY

Plan Statistics for BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN

401k plan membership statisitcs for BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN

Measure Date Value
2022: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01271
Total number of active participants reported on line 7a of the Form 55002022-01-01281
Number of retired or separated participants receiving benefits2022-01-015
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01286
2021: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01245
Total number of active participants reported on line 7a of the Form 55002021-01-01416
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01416
2020: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01353
Total number of active participants reported on line 7a of the Form 55002020-01-01245
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 participants2020-01-01245
2019: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01293
Total number of active participants reported on line 7a of the Form 55002019-01-01218
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01218
2018: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01175
Total number of active participants reported on line 7a of the Form 55002018-01-01235
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01235
2017: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01133
Total number of active participants reported on line 7a of the Form 55002017-01-01162
Total of all active and inactive participants2017-01-01162
2016: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01122
Total number of active participants reported on line 7a of the Form 55002016-01-01159
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01162

Form 5500 Responses for BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN

2022: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
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: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
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: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
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: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
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: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
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: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: BLACK & MCDONALD, INC. MEDICAL, DENTAL, LIFE AND DISABILITY PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan 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 number919941
Policy instance 1
Insurance contract or identification number919941
Number of Individuals Covered286
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,501
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT, CRITICAL ILLNESS, ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $414,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,501
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number919941
Policy instance 1
Insurance contract or identification number919941
Number of Individuals Covered416
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,960
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT, CRITICAL ILLNESS, ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $353,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,960
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number919941
Policy instance 1
Insurance contract or identification number919941
Number of Individuals Covered245
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $6,103
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $352,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,103
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number919941
Policy instance 1
Insurance contract or identification number919941
Number of Individuals Covered374
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $19,630
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $499,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,630
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50002461
Policy instance 1
Insurance contract or identification number50002461
Number of Individuals Covered238
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $24,826
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $152,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,049
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number12161900
Policy instance 2
Insurance contract or identification number12161900
Number of Individuals Covered514
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,395
Total amount of fees paid to insurance companyUSD $547
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $160,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,693
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBROKER BONUS
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number36732000
Policy instance 1
Insurance contract or identification number36732000
Number of Individuals Covered162
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $13,500
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,500
Insurance broker organization code?3
Insurance broker nameIMA, INC.
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50002461
Policy instance 2
Insurance contract or identification number50002461
Number of Individuals Covered208
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $15,847
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $119,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,887
Insurance broker organization code?3
Insurance broker nameBLUE CROSS BLUE SHIELD OF KC
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number12161900
Policy instance 3
Insurance contract or identification number12161900
Number of Individuals Covered333
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,335
Total amount of fees paid to insurance companyUSD $40
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,335
Amount paid for insurance broker fees40
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameIMA INC

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