401k Plan data: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN plan

BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 401k Plan overview

Plan Name	BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN
Plan identification number	502

BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

BITZER US, INC. has sponsored the creation of one or more 401k plans.

Company Name: BITZER US, INC.

Employer identification number (EIN): 581345338

NAIC Classification: 333410

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2019-01-01 BRANDON GRANT 2020-10-06 BRANDON GRANT 2020-10-06
502 2019-01-01 BRANDON GRANT 2020-10-06 BRANDON GRANT 2020-10-06
502 2018-01-01 BRANDON GRANT 2019-11-01 BRANDON GRANT 2019-11-01
502 2017-01-01 BRANDON GRANT 2019-11-01 BRANDON GRANT 2019-11-01
502 2016-01-01 BRANDON GRANT 2019-11-01
502 2015-01-01 BRANDON GRANT 2019-11-01
502 2014-01-01 BRANDON GRANT 2019-11-01 BRANDON GRANT 2019-11-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2019-01-01	BRANDON GRANT	2020-10-06	BRANDON GRANT	2020-10-06
502	2019-01-01	BRANDON GRANT	2020-10-06	BRANDON GRANT	2020-10-06
502	2018-01-01	BRANDON GRANT	2019-11-01	BRANDON GRANT	2019-11-01
502	2017-01-01	BRANDON GRANT	2019-11-01	BRANDON GRANT	2019-11-01
502	2016-01-01	BRANDON GRANT	2019-11-01
502	2015-01-01	BRANDON GRANT	2019-11-01
502	2014-01-01	BRANDON GRANT	2019-11-01	BRANDON GRANT	2019-11-01

Plan Statistics for BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN

401k plan membership statisitcs for BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN

Measure Date Value
2019: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 0
2018: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 186
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 186
2017: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 152
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 171
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 171
2016: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 152
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 152
2015: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 141
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 141
2014: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 119
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 119

Measure	Date	Value
2019: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	0
2018: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	186
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	186
2017: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	152
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	171
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	171
2016: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	152
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	152
2015: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	141
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	141
2014: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	119
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	119

Form 5500 Responses for BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN

2019: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	This submission is the final filing	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: BITZER US, INC. SUPPLEMENTAL BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

247145

Policy instance

Insurance contract or identification number	247145
Number of Individuals Covered	177
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $7,585
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $84,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,585
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

728373D

Policy instance

Insurance contract or identification number	728373D
Number of Individuals Covered	1
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $13
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	PFL-STAN AND WD-STAT
Welfare Benefit Premiums Paid to Carrier	USD $214
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13
Insurance broker organization code?	3

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

247145

Policy instance

Insurance contract or identification number	247145
Number of Individuals Covered	168
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $6,840
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $71,845
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

776183

Policy instance

Insurance contract or identification number	776183
Number of Individuals Covered	152
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,201
Total amount of fees paid to insurance company	USD $2,000
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $119,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

000BB315

Policy instance

Insurance contract or identification number	000BB315
Number of Individuals Covered	117
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $10,643
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $139,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,643
Insurance broker organization code?	3

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Company Name:	BITZER US, INC.
Employer identification number (EIN):	581345338
NAIC Classification:	333410