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DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 401k Plan overview

Plan NameDANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN
Plan identification number 502

DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

DANIEL BOONE COMMUNITY ACTION AGENCY, INC. has sponsored the creation of one or more 401k plans.

Company Name:DANIEL BOONE COMMUNITY ACTION AGENCY, INC.
Employer identification number (EIN):610728039
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-07-01MONA WHITAKER2023-09-28
5022021-07-01MONA WHITAKER2022-11-04
5022020-07-01MONA WHITAKER2021-12-16
5022019-07-01MONA WHITAKER2021-01-19
5022018-07-01MONA WHITAKER2020-01-13
5022017-07-01

Plan Statistics for DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN

401k plan membership statisitcs for DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN

Measure Date Value
2022: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01114
Total number of active participants reported on line 7a of the Form 55002022-07-01113
Total of all active and inactive participants2022-07-01113
2021: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01109
Total number of active participants reported on line 7a of the Form 55002021-07-01114
Total of all active and inactive participants2021-07-01114
2020: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01100
Total number of active participants reported on line 7a of the Form 55002020-07-01109
Total of all active and inactive participants2020-07-01109
2019: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01108
Total number of active participants reported on line 7a of the Form 55002019-07-0196
Total of all active and inactive participants2019-07-0196
2018: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01106
Total number of active participants reported on line 7a of the Form 55002018-07-01108
Total of all active and inactive participants2018-07-01108
2017: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01100
Total number of active participants reported on line 7a of the Form 55002017-07-01106
Total of all active and inactive participants2017-07-01106
Total participants2017-07-01106

Form 5500 Responses for DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN

2022: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: DANIEL BOONE COMMUNITY ACTION AGENCY, INC. ERISA PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01First time form 5500 has been submittedYes
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract numberMV0060
Policy instance 4
Insurance contract or identification numberMV0060
Number of Individuals Covered60
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $576
Vision 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 $576
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number928120
Policy instance 3
Insurance contract or identification number928120
Number of Individuals Covered49
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $21,890
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $502,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,575
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberH8376
Policy instance 2
Insurance contract or identification numberH8376
Number of Individuals Covered51
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $3,046
Total amount of fees paid to insurance companyUSD $121
Other welfare benefits providedACC, CANCER, HOSP, INT CARE STD
Welfare Benefit Premiums Paid to CarrierUSD $21,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,044
Amount paid for insurance broker fees73
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number010492
Policy instance 1
Insurance contract or identification number010492
Number of Individuals Covered113
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $1,440
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,440
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberH8376
Policy instance 2
Insurance contract or identification numberH8376
Number of Individuals Covered50
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $4,718
Total amount of fees paid to insurance companyUSD $44
Commission paid to Insurance BrokerUSD $1,785
Amount paid for insurance broker fees5
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number010492
Policy instance 1
Insurance contract or identification number010492
Number of Individuals Covered114
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $1,515
Total amount of fees paid to insurance companyUSD $202
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,515
Amount paid for insurance broker fees202
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberH8376
Policy instance 3
Insurance contract or identification numberH8376
Number of Individuals Covered52
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $2,959
Total amount of fees paid to insurance companyUSD $48
Other welfare benefits providedACC, CANCER, HOSP, INT CARE STD
Welfare Benefit Premiums Paid to CarrierUSD $24,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $801
Amount paid for insurance broker fees24
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number0528D180
Policy instance 2
Insurance contract or identification number0528D180
Number of Individuals Covered9
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00015927A
Policy instance 1
Insurance contract or identification number00015927A
Number of Individuals Covered109
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $936
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $936
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00015927A
Policy instance 1
Insurance contract or identification number00015927A
Number of Individuals Covered96
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $738
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $738
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberH8376
Policy instance 3
Insurance contract or identification numberH8376
Number of Individuals Covered48
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $3,428
Total amount of fees paid to insurance companyUSD $111
Other welfare benefits providedACC, CANCER, HOSP, INT CARE STD
Welfare Benefit Premiums Paid to CarrierUSD $27,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $889
Amount paid for insurance broker fees55
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number0528D180
Policy instance 2
Insurance contract or identification number0528D180
Number of Individuals Covered91
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberH8376
Policy instance 3
Insurance contract or identification numberH8376
Number of Individuals Covered53
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $4,214
Total amount of fees paid to insurance companyUSD $191
Other welfare benefits providedACC, CANCER, HOSP, INT CARE STD
Welfare Benefit Premiums Paid to CarrierUSD $29,874
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,313
Amount paid for insurance broker fees96
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number0528D180
Policy instance 2
Insurance contract or identification number0528D180
Number of Individuals Covered10
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00015927A
Policy instance 1
Insurance contract or identification number00015927A
Number of Individuals Covered108
Insurance policy start date2019-01-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $813
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $813
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00015927
Policy instance 3
Insurance contract or identification number00015927
Number of Individuals Covered12
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number607139
Policy instance 1
Insurance contract or identification number607139
Number of Individuals Covered105
Insurance policy start date2017-07-01
Insurance policy end date2018-01-01
Total amount of commissions paid to insurance brokerUSD $308
Total amount of fees paid to insurance companyUSD $23
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00015927A
Policy instance 2
Insurance contract or identification number00015927A
Number of Individuals Covered106
Insurance policy start date2018-01-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $493
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberH8376
Policy instance 4
Insurance contract or identification numberH8376
Number of Individuals Covered64
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $5,009
Total amount of fees paid to insurance companyUSD $164
Other welfare benefits providedACC, CANCER, HOSP, INT CARE, STD
Welfare Benefit Premiums Paid to CarrierUSD $34,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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