401k Plan data: BASS CABINET MANUFACTURING, INC. WRAP BENEFIT PLAN plan

BASS CABINET MANUFACTURING, INC. WRAP BENEFIT PLAN 401k Plan overview

Plan Name	BASS CABINET MANUFACTURING, INC. WRAP BENEFIT PLAN
Plan identification number	503

BASS CABINET MANUFACTURING, INC. WRAP BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance) 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

BASS CABINET MANUFACTURING, INC. has sponsored the creation of one or more 401k plans.

Company Name: BASS CABINET MANUFACTURING, INC.

Employer identification number (EIN): 860526783

NAIC Classification: 337000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BASS CABINET MANUFACTURING, INC. WRAP BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2021-01-01 BRITTNEY KILLEN 2022-07-07
503 2020-01-01 BRITTNEY KILLEN 2021-05-14
503 2019-01-01 BRITTNEY KILLEN 2020-06-19
503 2018-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
503	2021-01-01	BRITTNEY KILLEN	2022-07-07
503	2020-01-01	BRITTNEY KILLEN	2021-05-14
503	2019-01-01	BRITTNEY KILLEN	2020-06-19
503	2018-01-01

Form 5500 Responses for BASS CABINET MANUFACTURING, INC. WRAP BENEFIT PLAN

2021: BASS CABINET MANUFACTURING, INC. WRAP BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: BASS CABINET MANUFACTURING, INC. WRAP BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: BASS CABINET MANUFACTURING, INC. WRAP BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: BASS CABINET MANUFACTURING, INC. WRAP BENEFIT 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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	910980
Policy instance	5
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number	108711BH
Policy instance	4
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	108711
Policy instance	3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	10137931001
Policy instance	2
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-046104
Policy instance	1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	910980
Policy instance	5
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number	108711BH
Policy instance	4
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	108711
Policy instance	3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	10137931001
Policy instance	2
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-046104
Policy instance	1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	910980
Policy instance	5
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number	0108711BH
Policy instance	4
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	108711
Policy instance	3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	10137931001
Policy instance	2
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-046104
Policy instance	1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	910980
Policy instance	4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	10137931001
Policy instance	3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-046104
Policy instance	2
HEALTH NET OF AZ (National Association of Insurance Commissioners NAIC id number: 95206 )
Policy contract number	AM370A ET AL
Policy instance	1

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Company Name:	BASS CABINET MANUFACTURING, INC.
Employer identification number (EIN):	860526783
NAIC Classification:	337000