401k Plan data: BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN plan

BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN 401k Plan overview

Plan Name	BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN
Plan identification number	501

BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Temporary disability (accident and sickness) 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

BLAZER ELECTRIC SUPPLY MANAGEMENT COMPANY has sponsored the creation of one or more 401k plans.

Company Name: BLAZER ELECTRIC SUPPLY MANAGEMENT COMPANY

Employer identification number (EIN): 943482972

NAIC Classification: 423600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-06-01 JOSH ROWLEY 2023-12-05

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-06-01	JOSH ROWLEY	2023-12-05

Plan Statistics for BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN

401k plan membership statisitcs for BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN

Measure Date Value
2022: BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year 2022-06-01 100
Total number of active participants reported on line 7a of the Form 5500 2022-06-01 81
Number of retired or separated participants receiving benefits 2022-06-01 0
Number of other retired or separated participants entitled to future benefits 2022-06-01 0
Total of all active and inactive participants 2022-06-01 81
Number of employers contributing to the scheme 2022-06-01 0

Measure	Date	Value
2022: BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year	2022-06-01	100
Total number of active participants reported on line 7a of the Form 5500	2022-06-01	81
Number of retired or separated participants receiving benefits	2022-06-01	0
Number of other retired or separated participants entitled to future benefits	2022-06-01	0
Total of all active and inactive participants	2022-06-01	81
Number of employers contributing to the scheme	2022-06-01	0

Form 5500 Responses for BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN

2022: BLAZER ELECTRIC SUPPLY MANAGMENT COMPANY HEALTH PLAN 2022 form 5500 responses
2022-06-01	Type of plan entity	Single employer plan
2022-06-01	First time form 5500 has been submitted	Yes
2022-06-01	Plan funding arrangement – Insurance	Yes
2022-06-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-06-01	Plan benefit arrangement – Insurance	Yes
2022-06-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30033482

Policy instance

Insurance contract or identification number	30033482
Number of Individuals Covered	71
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $906
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $906
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

DELTA DENTAL OF COLORADO (National Association of Insurance Commissioners NAIC id number: 55875 )

Policy contract number

11275

Policy instance

Insurance contract or identification number	11275
Number of Individuals Covered	156
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $5,754
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $57,358
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,754
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

618953

Policy instance

Insurance contract or identification number	618953
Number of Individuals Covered	117
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $37,861
Total amount of fees paid to insurance company	USD $1,040
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $382,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $27,044
Amount paid for insurance broker fees	1040
Additional information about fees paid to insurance broker	INCENTIVE COMPENSATION
Insurance broker organization code?	3

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

Policy contract number

881120G

Policy instance

Insurance contract or identification number	881120G
Number of Individuals Covered	97
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $1,066
Total amount of fees paid to insurance company	USD $157
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,066
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	BONUS

Potentially related plans

BLAZER ELECTRIC 401(K) PLAN [EIN = 752802684]

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	BLAZER ELECTRIC SUPPLY MANAGEMENT COMPANY
Employer identification number (EIN):	943482972
NAIC Classification:	423600