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EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC.
Plan identification number 502

EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

DEBBIE RENFRO AKA ITS A BUFFALO INC. has sponsored the creation of one or more 401k plans.

Company Name:DEBBIE RENFRO AKA ITS A BUFFALO INC.
Employer identification number (EIN):202989954
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-05-01
5022021-05-01
5022020-05-01
5022019-05-01
5022018-05-01
5022017-05-01DEBBIE RENFRO
5022016-05-01DEBBIE RENFRO
5022016-05-01DEBBIE RENFRO
5022015-05-01DEBBIE RENFRO
5022014-05-01DEBBIE RENFRO
5022013-05-01DEBBIE RENFRO
5022012-05-01DEBBIE RENFRO
5022011-05-01DEBBIE RENFRO

Plan Statistics for EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC.

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC.

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2022 401k membership
Total participants, beginning-of-year2022-05-013
Total number of active participants reported on line 7a of the Form 55002022-05-011
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-011
2021: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2021 401k membership
Total participants, beginning-of-year2021-05-013
Total number of active participants reported on line 7a of the Form 55002021-05-015
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-015
2020: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2020 401k membership
Total participants, beginning-of-year2020-05-0115
Total number of active participants reported on line 7a of the Form 55002020-05-015
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-015
2019: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2019 401k membership
Total participants, beginning-of-year2019-05-018
Total number of active participants reported on line 7a of the Form 55002019-05-016
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-016
2018: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2018 401k membership
Total participants, beginning-of-year2018-05-0110
Total number of active participants reported on line 7a of the Form 55002018-05-019
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-019
2017: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2017 401k membership
Total participants, beginning-of-year2017-05-017
Total number of active participants reported on line 7a of the Form 55002017-05-014
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-014
2016: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2016 401k membership
Total participants, beginning-of-year2016-05-0115
Total number of active participants reported on line 7a of the Form 55002016-05-017
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-017
2015: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2015 401k membership
Total participants, beginning-of-year2015-05-017
Total number of active participants reported on line 7a of the Form 55002015-05-017
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-017
2014: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2014 401k membership
Total participants, beginning-of-year2014-05-018
Total number of active participants reported on line 7a of the Form 55002014-05-015
Number of retired or separated participants receiving benefits2014-05-010
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-015
2013: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2013 401k membership
Total participants, beginning-of-year2013-05-014
Total number of active participants reported on line 7a of the Form 55002013-05-015
Number of retired or separated participants receiving benefits2013-05-010
Number of other retired or separated participants entitled to future benefits2013-05-010
Total of all active and inactive participants2013-05-015
2012: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2012 401k membership
Total participants, beginning-of-year2012-05-016
Total number of active participants reported on line 7a of the Form 55002012-05-014
Number of retired or separated participants receiving benefits2012-05-010
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-014
2011: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2011 401k membership
Total participants, beginning-of-year2011-05-017
Total number of active participants reported on line 7a of the Form 55002011-05-016
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-016

Financial Data on EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC.

Measure Date Value
2023 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2023 401k financial data
Total income from all sources2023-04-30$51,160
Expenses. Total of all expenses incurred2023-04-30$51,160
Benefits paid (including direct rollovers)2023-04-30$24,942
Value of fidelity bond covering the plan2023-04-30$6,000
Expenses. Other expenses not covered elsewhere2023-04-30$26,218
Net income (gross income less expenses)2023-04-30$0
Net plan assets at end of year (total assets less liabilities)2023-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$0
Total contributions received or receivable from employer(s)2023-04-30$51,160
2022 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2022 401k financial data
Total income from all sources2022-04-30$40,648
Expenses. Total of all expenses incurred2022-04-30$40,648
Benefits paid (including direct rollovers)2022-04-30$20,078
Total plan assets at beginning of year2022-04-30$0
Value of fidelity bond covering the plan2022-04-30$2,000
Expenses. Other expenses not covered elsewhere2022-04-30$20,570
Net income (gross income less expenses)2022-04-30$0
Net plan assets at end of year (total assets less liabilities)2022-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$0
Total contributions received or receivable from employer(s)2022-04-30$40,648
2021 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$43,031
Expenses. Total of all expenses incurred2021-04-30$43,031
Benefits paid (including direct rollovers)2021-04-30$20,599
Total plan assets at end of year2021-04-30$0
Total plan assets at beginning of year2021-04-30$0
Value of fidelity bond covering the plan2021-04-30$10,000
Expenses. Other expenses not covered elsewhere2021-04-30$22,432
Net income (gross income less expenses)2021-04-30$0
Net plan assets at end of year (total assets less liabilities)2021-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$0
Total contributions received or receivable from employer(s)2021-04-30$43,031
2020 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2020 401k financial data
Total plan liabilities at end of year2020-04-30$0
Total plan liabilities at beginning of year2020-04-30$0
Total income from all sources2020-04-30$41,203
Expenses. Total of all expenses incurred2020-04-30$41,203
Benefits paid (including direct rollovers)2020-04-30$19,267
Total plan assets at end of year2020-04-30$0
Total plan assets at beginning of year2020-04-30$0
Value of fidelity bond covering the plan2020-04-30$10,000
Expenses. Other expenses not covered elsewhere2020-04-30$21,936
Net income (gross income less expenses)2020-04-30$0
Net plan assets at end of year (total assets less liabilities)2020-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$0
Total contributions received or receivable from employer(s)2020-04-30$41,203
2018 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2018 401k financial data
Total plan liabilities at end of year2018-04-30$0
Total plan liabilities at beginning of year2018-04-30$0
Total income from all sources2018-04-30$52,222
Expenses. Total of all expenses incurred2018-04-30$52,222
Benefits paid (including direct rollovers)2018-04-30$24,372
Total plan assets at end of year2018-04-30$0
Total plan assets at beginning of year2018-04-30$0
Value of fidelity bond covering the plan2018-04-30$10,000
Expenses. Other expenses not covered elsewhere2018-04-30$27,850
Net income (gross income less expenses)2018-04-30$0
Net plan assets at end of year (total assets less liabilities)2018-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$0
Total contributions received or receivable from employer(s)2018-04-30$52,222
2017 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2017 401k financial data
Total plan liabilities at end of year2017-04-30$0
Total plan liabilities at beginning of year2017-04-30$0
Total income from all sources2017-04-30$55,282
Expenses. Total of all expenses incurred2017-04-30$55,282
Benefits paid (including direct rollovers)2017-04-30$24,564
Total plan assets at end of year2017-04-30$0
Total plan assets at beginning of year2017-04-30$0
Value of fidelity bond covering the plan2017-04-30$10,000
Expenses. Other expenses not covered elsewhere2017-04-30$30,718
Net income (gross income less expenses)2017-04-30$0
Net plan assets at end of year (total assets less liabilities)2017-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$0
Total contributions received or receivable from employer(s)2017-04-30$55,282
2016 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2016 401k financial data
Total plan liabilities at end of year2016-04-30$0
Total plan liabilities at beginning of year2016-04-30$341
Total income from all sources2016-04-30$60,107
Expenses. Total of all expenses incurred2016-04-30$60,107
Benefits paid (including direct rollovers)2016-04-30$25,010
Total plan assets at end of year2016-04-30$0
Total plan assets at beginning of year2016-04-30$341
Value of fidelity bond covering the plan2016-04-30$10,000
Expenses. Other expenses not covered elsewhere2016-04-30$35,097
Net income (gross income less expenses)2016-04-30$0
Net plan assets at end of year (total assets less liabilities)2016-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2016-04-30$0
Total contributions received or receivable from employer(s)2016-04-30$60,107
2015 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2015 401k financial data
Total plan liabilities at end of year2015-04-30$341
Total plan liabilities at beginning of year2015-04-30$911
Total income from all sources2015-04-30$41,145
Expenses. Total of all expenses incurred2015-04-30$65,548
Benefits paid (including direct rollovers)2015-04-30$42,491
Total plan assets at end of year2015-04-30$341
Total plan assets at beginning of year2015-04-30$25,314
Value of fidelity bond covering the plan2015-04-30$10,000
Expenses. Other expenses not covered elsewhere2015-04-30$23,057
Net income (gross income less expenses)2015-04-30$-24,403
Net plan assets at end of year (total assets less liabilities)2015-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$24,403
Total contributions received or receivable from employer(s)2015-04-30$41,145
2014 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2014 401k financial data
Total plan liabilities at end of year2014-04-30$911
Total plan liabilities at beginning of year2014-04-30$501
Total income from all sources2014-04-30$31,093
Expenses. Total of all expenses incurred2014-04-30$38,417
Benefits paid (including direct rollovers)2014-04-30$19,880
Total plan assets at end of year2014-04-30$25,314
Total plan assets at beginning of year2014-04-30$32,228
Value of fidelity bond covering the plan2014-04-30$10,000
Expenses. Other expenses not covered elsewhere2014-04-30$18,537
Net income (gross income less expenses)2014-04-30$-7,324
Net plan assets at end of year (total assets less liabilities)2014-04-30$24,403
Net plan assets at beginning of year (total assets less liabilities)2014-04-30$31,727
Total contributions received or receivable from employer(s)2014-04-30$31,093
2013 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2013 401k financial data
Total plan liabilities at end of year2013-04-30$501
Total plan liabilities at beginning of year2013-04-30$593
Total income from all sources2013-04-30$25,718
Expenses. Total of all expenses incurred2013-04-30$14,894
Benefits paid (including direct rollovers)2013-04-30$1,881
Total plan assets at end of year2013-04-30$32,228
Total plan assets at beginning of year2013-04-30$21,496
Expenses. Other expenses not covered elsewhere2013-04-30$13,013
Net income (gross income less expenses)2013-04-30$10,824
Net plan assets at end of year (total assets less liabilities)2013-04-30$31,727
Net plan assets at beginning of year (total assets less liabilities)2013-04-30$20,903
Total contributions received or receivable from employer(s)2013-04-30$25,718
2012 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2012 401k financial data
Total plan liabilities at end of year2012-04-30$593
Total plan liabilities at beginning of year2012-04-30$401
Total income from all sources2012-04-30$29,472
Expenses. Total of all expenses incurred2012-04-30$17,578
Benefits paid (including direct rollovers)2012-04-30$2,824
Total plan assets at end of year2012-04-30$21,496
Total plan assets at beginning of year2012-04-30$9,410
Expenses. Other expenses not covered elsewhere2012-04-30$14,754
Net income (gross income less expenses)2012-04-30$11,894
Net plan assets at end of year (total assets less liabilities)2012-04-30$20,903
Net plan assets at beginning of year (total assets less liabilities)2012-04-30$9,009
Total contributions received or receivable from employer(s)2012-04-30$29,472
2011 : EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2011 401k financial data
Total plan liabilities at end of year2011-04-30$401
Total plan liabilities at beginning of year2011-04-30$0
Total income from all sources2011-04-30$25,617
Expenses. Total of all expenses incurred2011-04-30$16,608
Benefits paid (including direct rollovers)2011-04-30$3,912
Total plan assets at end of year2011-04-30$9,410
Total plan assets at beginning of year2011-04-30$0
Expenses. Other expenses not covered elsewhere2011-04-30$12,696
Net income (gross income less expenses)2011-04-30$9,009
Net plan assets at end of year (total assets less liabilities)2011-04-30$9,009
Net plan assets at beginning of year (total assets less liabilities)2011-04-30$0
Total contributions received or receivable from employer(s)2011-04-30$25,617

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC.

2022: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – TrustYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement - TrustYes
2016: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – TrustYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement - TrustYes
2015: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – TrustYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement - TrustYes
2014: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement - TrustYes
2013: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2012: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337NFA0028
Policy instance 1
Insurance contract or identification number11337NFA0028
Number of Individuals Covered1
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $21,539
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337NFA0028
Policy instance 1
Insurance contract or identification number11337NFA0028
Number of Individuals Covered6
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $17,229
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337NFA0028
Policy instance 1
Insurance contract or identification number11337NFA0028
Number of Individuals Covered5
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $18,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337NFA0028
Policy instance 1
Insurance contract or identification number11337NFA0028
Number of Individuals Covered6
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $17,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337 NFA 0028
Policy instance 1
Insurance contract or identification number11337 NFA 0028
Number of Individuals Covered12
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $23,810
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337 NFA 0028
Policy instance 1
Insurance contract or identification number11337 NFA 0028
Number of Individuals Covered4
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $22,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337 NFA 0028
Policy instance 1
Insurance contract or identification number11337 NFA 0028
Number of Individuals Covered10
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $24,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337 NFA 0028
Policy instance 1
Insurance contract or identification number11337 NFA 0028
Number of Individuals Covered5
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $16,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337 NFA 0028
Policy instance 1
Insurance contract or identification number11337 NFA 0028
Number of Individuals Covered5
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $13,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337 NFA 0028
Policy instance 1
Insurance contract or identification number11337 NFA 0028
Number of Individuals Covered4
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $8,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337 NFA 0028
Policy instance 1
Insurance contract or identification number11337 NFA 0028
Number of Individuals Covered10
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $9,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number11337 NFA 0028
Policy instance 1
Insurance contract or identification number11337 NFA 0028
Number of Individuals Covered11
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $9,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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