THREE BEARS ALASKA, INC. MEDICAL PLAN 401k Plan overview
| Plan Name | THREE BEARS ALASKA, INC. MEDICAL PLAN |
| Plan identification number | 503 |
THREE BEARS ALASKA, INC. MEDICAL PLAN Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Health (other than dental or vision)
- Vision
|
401k Sponsoring company profile
THREE BEARS ALASKA, INC. has sponsored the creation of one or more 401k plans.
| Company Name: | THREE BEARS ALASKA, INC. |
| Employer identification number (EIN): | 920081221 |
| NAIC Classification: | 445110 |
| NAIC Description: | Supermarkets and Other Grocery (except Convenience) Stores |
Additional information about THREE BEARS ALASKA, INC.
| Jurisdiction of Incorporation: | Alaska Department Commerce, Community & Economic Development |
| Incorporation Date: | 1981-05-19 |
| Company Identification Number: | 24136D |
| Legal Registered Office Address: |
445 N. PITTMAN ROAD, SUITE B
WASILLA
United States of America (USA)
99623
|
More information about THREE BEARS ALASKA, INC.
Form 5500 Filing Information
Submission information for form 5500 for 401k plan THREE BEARS ALASKA, INC. MEDICAL PLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 503 | 2020-01-01 | RACHEL SANFORD | 2021-08-31 | | |
| 503 | 2020-01-01 | RACHEL SANFORD | 2022-09-19 | | |
Plan Statistics for THREE BEARS ALASKA, INC. MEDICAL PLAN
401k plan membership statisitcs for THREE BEARS ALASKA, INC. MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2020: THREE BEARS ALASKA, INC. MEDICAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 145 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 143 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 143 |
| Number of employers contributing to the scheme | 2020-01-01 | 0 |
Form 5500 Responses for THREE BEARS ALASKA, INC. MEDICAL PLAN
| 2020: THREE BEARS ALASKA, INC. MEDICAL PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | First time form 5500 has been submitted | Yes |
| 2020-01-01 | Submission has been amended | Yes |
| 2020-01-01 | This submission is the final filing | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC. (National Association of Insurance Commissioners NAIC id number: 11677 ) |
| Policy contract number | 4019283 |
| Policy instance | 1 |
| Insurance contract or identification number | 4019283 | | Number of Individuals Covered | 492 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $77,005 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,487,836 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $77,005 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
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