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BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 401k Plan overview

Plan NameBOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN
Plan identification number 504

BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

BOWL AMERICA INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name:BOWL AMERICA INCORPORATED
Employer identification number (EIN):540646173
NAIC Classification:713900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042018-11-01CHERYL DRAGOO2020-02-07
5042017-11-01CHERYL A. DRAGOO2019-05-09
5042016-11-01CHERYL A DRAGOO CHERYL A DRAGOO2018-03-12
5042015-11-01CHERYL A DRAGOO
5042014-11-01CHERYL DRAGOO
5042013-11-01CHERYL A DRAGOO
5042012-11-01CHERYL A DRAGOO CHERYL A DRAGOO2014-05-28
5042011-11-01CHERYL A DRAGOO CHERYL A DRAGOO2013-09-30
5042010-11-01BRAD YOUNG
5042009-11-01BRAD YOUNG
5042008-11-01BRAD YOUNG

Form 5500 Responses for BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN

2018: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – InsuranceYes
2017: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – InsuranceYes
2016: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingNo
2016-11-01This return/report is a short plan year return/report (less than 12 months)No
2016-11-01Plan is a collectively bargained planNo
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – InsuranceYes
2015: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingNo
2015-11-01This return/report is a short plan year return/report (less than 12 months)No
2015-11-01Plan is a collectively bargained planNo
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – InsuranceYes
2014: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01Submission has been amendedNo
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planNo
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – InsuranceYes
2013: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Submission has been amendedNo
2013-11-01This submission is the final filingNo
2013-11-01This return/report is a short plan year return/report (less than 12 months)No
2013-11-01Plan is a collectively bargained planNo
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan benefit arrangement – InsuranceYes
2012: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – InsuranceYes
2011: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Submission has been amendedYes
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)No
2011-11-01Plan is a collectively bargained planNo
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan benefit arrangement – InsuranceYes
2010: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2010 form 5500 responses
2010-11-01Type of plan entitySingle employer plan
2010-11-01First time form 5500 has been submittedYes
2010-11-01Submission has been amendedNo
2010-11-01This submission is the final filingNo
2010-11-01This return/report is a short plan year return/report (less than 12 months)No
2010-11-01Plan is a collectively bargained planNo
2010-11-01Plan funding arrangement – InsuranceYes
2010-11-01Plan benefit arrangement – InsuranceYes
2009: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01First time form 5500 has been submittedYes
2009-11-01Submission has been amendedNo
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan benefit arrangement – InsuranceYes
2008: BOWL AMERICA EMPLOYEE HOSPITALIZATION AND DENTAL PLAN 2008 form 5500 responses
2008-11-01Type of plan entitySingle employer plan
2008-11-01First time form 5500 has been submittedYes
2008-11-01Submission has been amendedNo
2008-11-01This submission is the final filingNo
2008-11-01This return/report is a short plan year return/report (less than 12 months)No
2008-11-01Plan is a collectively bargained planNo
2008-11-01Plan funding arrangement – InsuranceYes
2008-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number21927
Policy instance 1
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5470278
Policy instance 2
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5470278
Policy instance 2
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number21927 (MA)
Policy instance 1
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5470278
Policy instance 1
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number21927
Policy instance 2
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number21927
Policy instance 2
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5470278
Policy instance 1
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number20126
Policy instance 2
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5470278
Policy instance 3
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number21927
Policy instance 1
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number20126
Policy instance 1
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number21927
Policy instance 2
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 47060 )
Policy contract number877939 HNOSHORT
Policy instance 1
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 95484 )
Policy contract number877939
Policy instance 2
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number20126
Policy instance 3
AETNA INC. (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberUS412781
Policy instance 1
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number20126
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number713014
Policy instance 1
CITIZENS SECURITY (National Association of Insurance Commissioners NAIC id number: 61921 )
Policy contract number20126
Policy instance 2

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