401k Plan data: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES plan

WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 401k Plan overview

Plan Name	WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES
Plan identification number	503

WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

HONEY FARMS, INC. has sponsored the creation of one or more 401k plans.

Company Name: HONEY FARMS, INC.

Employer identification number (EIN): 042453813

NAIC Classification: 445299
NAIC Description: All Other Specialty Food Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2016-03-01 DAVID MURDOCK
503 2015-03-01 SUZANNE RIVERS
503 2014-03-01 SHEILA SMITH
503 2013-03-01 SHEILA SMITH
503 2012-03-01 SHEILA SMITH

Plan id#	Filing Submission Date	Name of Administrator
503	2016-03-01	DAVID MURDOCK
503	2015-03-01	SUZANNE RIVERS
503	2014-03-01	SHEILA SMITH
503	2013-03-01	SHEILA SMITH
503	2012-03-01	SHEILA SMITH

Plan Statistics for WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES

401k plan membership statisitcs for WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES

Measure Date Value
2016: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2016 401k membership
Total participants, beginning-of-year 2016-03-01 167
Total number of active participants reported on line 7a of the Form 5500 2016-03-01 124
Number of retired or separated participants receiving benefits 2016-03-01 0
Number of other retired or separated participants entitled to future benefits 2016-03-01 0
Total of all active and inactive participants 2016-03-01 124
2015: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2015 401k membership
Total participants, beginning-of-year 2015-03-01 116
Total number of active participants reported on line 7a of the Form 5500 2015-03-01 167
Number of retired or separated participants receiving benefits 2015-03-01 0
Number of other retired or separated participants entitled to future benefits 2015-03-01 0
Total of all active and inactive participants 2015-03-01 167
2014: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2014 401k membership
Total participants, beginning-of-year 2014-03-01 104
Total number of active participants reported on line 7a of the Form 5500 2014-03-01 111
Total of all active and inactive participants 2014-03-01 111
Total participants 2014-03-01 111
2013: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2013 401k membership
Total participants, beginning-of-year 2013-03-01 112
Total number of active participants reported on line 7a of the Form 5500 2013-03-01 104
Total of all active and inactive participants 2013-03-01 104
Total participants 2013-03-01 104
2012: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2012 401k membership
Total participants, beginning-of-year 2012-03-01 116
Total number of active participants reported on line 7a of the Form 5500 2012-03-01 112
Total of all active and inactive participants 2012-03-01 112
Total participants 2012-03-01 112

Measure	Date	Value
2016: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2016 401k membership
Total participants, beginning-of-year	2016-03-01	167
Total number of active participants reported on line 7a of the Form 5500	2016-03-01	124
Number of retired or separated participants receiving benefits	2016-03-01	0
Number of other retired or separated participants entitled to future benefits	2016-03-01	0
Total of all active and inactive participants	2016-03-01	124
2015: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2015 401k membership
Total participants, beginning-of-year	2015-03-01	116
Total number of active participants reported on line 7a of the Form 5500	2015-03-01	167
Number of retired or separated participants receiving benefits	2015-03-01	0
Number of other retired or separated participants entitled to future benefits	2015-03-01	0
Total of all active and inactive participants	2015-03-01	167
2014: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2014 401k membership
Total participants, beginning-of-year	2014-03-01	104
Total number of active participants reported on line 7a of the Form 5500	2014-03-01	111
Total of all active and inactive participants	2014-03-01	111
Total participants	2014-03-01	111
2013: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2013 401k membership
Total participants, beginning-of-year	2013-03-01	112
Total number of active participants reported on line 7a of the Form 5500	2013-03-01	104
Total of all active and inactive participants	2013-03-01	104
Total participants	2013-03-01	104
2012: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2012 401k membership
Total participants, beginning-of-year	2012-03-01	116
Total number of active participants reported on line 7a of the Form 5500	2012-03-01	112
Total of all active and inactive participants	2012-03-01	112
Total participants	2012-03-01	112

Form 5500 Responses for WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES

2016: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2016 form 5500 responses
2016-03-01	Type of plan entity	Single employer plan
2016-03-01	Submission has been amended	No
2016-03-01	This submission is the final filing	No
2016-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-03-01	Plan is a collectively bargained plan	No
2016-03-01	Plan funding arrangement – Insurance	Yes
2016-03-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-03-01	Plan benefit arrangement – Insurance	Yes
2016-03-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2015 form 5500 responses
2015-03-01	Type of plan entity	Single employer plan
2015-03-01	Submission has been amended	No
2015-03-01	This submission is the final filing	No
2015-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-03-01	Plan is a collectively bargained plan	No
2015-03-01	Plan funding arrangement – Insurance	Yes
2015-03-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-03-01	Plan benefit arrangement – Insurance	Yes
2015-03-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2014 form 5500 responses
2014-03-01	Type of plan entity	Single employer plan
2014-03-01	Submission has been amended	No
2014-03-01	This submission is the final filing	No
2014-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-03-01	Plan is a collectively bargained plan	No
2014-03-01	Plan funding arrangement – Insurance	Yes
2014-03-01	Plan benefit arrangement – Insurance	Yes
2013: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2013 form 5500 responses
2013-03-01	Type of plan entity	Single employer plan
2013-03-01	Submission has been amended	No
2013-03-01	This submission is the final filing	No
2013-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-03-01	Plan is a collectively bargained plan	No
2013-03-01	Plan funding arrangement – Insurance	Yes
2013-03-01	Plan benefit arrangement – Insurance	Yes
2012: WELFARE BENEFIT PLAN FOR HONEY FARMS, INC. EMPLOYEES 2012 form 5500 responses
2012-03-01	Type of plan entity	Single employer plan
2012-03-01	Submission has been amended	No
2012-03-01	This submission is the final filing	No
2012-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-03-01	Plan is a collectively bargained plan	No
2012-03-01	Plan funding arrangement – Insurance	Yes
2012-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )

Policy contract number

2980

Policy instance

Insurance contract or identification number	2980
Number of Individuals Covered	167
Insurance policy start date	2015-03-01
Insurance policy end date	2016-02-29
Total amount of commissions paid to insurance broker	USD $3,802
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $54,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,802
Insurance broker organization code?	3
Insurance broker name	CBIZ BENEFITS AND INSURANCE SVCS.

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

338407

Policy instance

Insurance contract or identification number	338407
Number of Individuals Covered	117
Insurance policy start date	2015-03-01
Insurance policy end date	2015-05-31
Total amount of commissions paid to insurance broker	USD $713
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $5,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $713
Insurance broker organization code?	3
Insurance broker name	MARK W. SMILEY

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0AWSN

Policy instance

Insurance contract or identification number	GLUG0AWSN
Number of Individuals Covered	107
Insurance policy start date	2015-06-01
Insurance policy end date	2016-02-29
Total amount of commissions paid to insurance broker	USD $1,076
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $10,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,076
Insurance broker organization code?	3
Insurance broker name	GROUP INSURANCE SOLUTIONS, INC.

TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )

Policy contract number

68795000

Policy instance

Insurance contract or identification number	68795000
Number of Individuals Covered	142
Insurance policy start date	2014-06-01
Insurance policy end date	2015-05-31
Total amount of commissions paid to insurance broker	USD $20,283
Total amount of fees paid to insurance company	USD $175
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $778,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,283
Amount paid for insurance broker fees	175
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	CBIZ BENEFITS AND INSURANCE SVCS.

TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 )

Policy contract number

44884000

Policy instance

Insurance contract or identification number	44884000
Number of Individuals Covered	1
Insurance policy start date	2014-06-01
Insurance policy end date	2015-05-31
Total amount of commissions paid to insurance broker	USD $189
Total amount of fees paid to insurance company	USD $2
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $7,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $189
Amount paid for insurance broker fees	2
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	CBIZ BENEFITS AND INSURANCE SVCS.

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00338407

Policy instance

Insurance contract or identification number	00338407
Number of Individuals Covered	111
Insurance policy start date	2014-03-01
Insurance policy end date	2015-02-28
Total amount of commissions paid to insurance broker	USD $2,410
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD & D; SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $20,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $345
Insurance broker organization code?	3
Insurance broker name	ARTHUR ANDREOLI

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00338407

Policy instance

Insurance contract or identification number	00338407
Number of Individuals Covered	104
Insurance policy start date	2013-03-01
Insurance policy end date	2014-02-28
Total amount of commissions paid to insurance broker	USD $2,299
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,299
Insurance broker organization code?	3
Insurance broker name	ARTHUR ANDREOLI

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00338407

Policy instance

Insurance contract or identification number	00338407
Number of Individuals Covered	112
Insurance policy start date	2012-03-01
Insurance policy end date	2013-02-28
Total amount of commissions paid to insurance broker	USD $2,456
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,312
Insurance broker organization code?	3
Insurance broker name	ARTHUR ANDREOLI

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Company Name:	HONEY FARMS, INC.
Employer identification number (EIN):	042453813
NAIC Classification:	445299
NAIC Description:	All Other Specialty Food Stores