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| Plan Name | EMPRESAS BERRIOS WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | EMPRESAS BERRIOS GROUP LIFE BENEFIT PLAN |
| Employer identification number (EIN): | 660580021 |
| NAIC Classification: | 812990 |
| NAIC Description: | All Other Personal Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-09-01 | ||||
| 501 | 2016-09-01 | ANA RODRIGUEZ | ANA RODRIGUEZ | 2018-04-25 | |
| 501 | 2016-09-01 | ANA RODRIGUEZ | 2018-04-25 | ||
| 501 | 2015-09-01 | ANA RODRIGUEZ | |||
| 501 | 2015-09-01 | ||||
| 501 | 2014-09-01 | ANA RODRIGUEZ |
| Measure | Date | Value |
|---|---|---|
| 2017: EMPRESAS BERRIOS WELFARE BENEFIT PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-09-01 | 417 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 416 |
| Total of all active and inactive participants | 2017-09-01 | 416 |
| Total participants | 2017-09-01 | 416 |
| 2016: EMPRESAS BERRIOS WELFARE BENEFIT PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-09-01 | 419 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 417 |
| Number of retired or separated participants receiving benefits | 2016-09-01 | 6 |
| Number of other retired or separated participants entitled to future benefits | 2016-09-01 | 99 |
| Total of all active and inactive participants | 2016-09-01 | 522 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-09-01 | 0 |
| Total participants | 2016-09-01 | 522 |
| Number of participants with account balances | 2016-09-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-09-01 | 0 |
| Number of employers contributing to the scheme | 2016-09-01 | 0 |
| 2015: EMPRESAS BERRIOS WELFARE BENEFIT PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-09-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 419 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 6 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 63 |
| Total of all active and inactive participants | 2015-09-01 | 488 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-09-01 | 1 |
| Total participants | 2015-09-01 | 489 |
| 2014: EMPRESAS BERRIOS WELFARE BENEFIT PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-09-01 | 484 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 426 |
| Number of other retired or separated participants entitled to future benefits | 2014-09-01 | 53 |
| Total of all active and inactive participants | 2014-09-01 | 479 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-09-01 | 1 |
| Total participants | 2014-09-01 | 480 |
| 2017: EMPRESAS BERRIOS WELFARE BENEFIT PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-09-01 | Type of plan entity | Single employer plan |
| 2017-09-01 | Submission has been amended | No |
| 2017-09-01 | This submission is the final filing | No |
| 2017-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-09-01 | Plan is a collectively bargained plan | No |
| 2017-09-01 | Plan funding arrangement – Insurance | Yes |
| 2017-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: EMPRESAS BERRIOS WELFARE BENEFIT PLAN 2016 form 5500 responses | ||
| 2016-09-01 | Type of plan entity | Single employer plan |
| 2016-09-01 | Submission has been amended | Yes |
| 2016-09-01 | This submission is the final filing | No |
| 2016-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-09-01 | Plan is a collectively bargained plan | No |
| 2016-09-01 | Plan funding arrangement – Insurance | Yes |
| 2016-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: EMPRESAS BERRIOS WELFARE BENEFIT PLAN 2015 form 5500 responses | ||
| 2015-09-01 | Type of plan entity | Single employer plan |
| 2015-09-01 | Submission has been amended | Yes |
| 2015-09-01 | This submission is the final filing | No |
| 2015-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-09-01 | Plan is a collectively bargained plan | No |
| 2015-09-01 | Plan funding arrangement – Insurance | Yes |
| 2015-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: EMPRESAS BERRIOS WELFARE BENEFIT PLAN 2014 form 5500 responses | ||
| 2014-09-01 | Type of plan entity | Single employer plan |
| 2014-09-01 | Submission has been amended | No |
| 2014-09-01 | This submission is the final filing | No |
| 2014-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-09-01 | Plan is a collectively bargained plan | No |
| 2014-09-01 | Plan funding arrangement – Insurance | Yes |
| 2014-09-01 | Plan benefit arrangement – Insurance | Yes |
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | SP0005155 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
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| FIRST MEDICAL HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95722 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 6150,6151,6152 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
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| MCS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60030 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 79-791118 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||
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