401k Plan data: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. plan

EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 401k Plan overview

Plan Name	EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC.
Plan identification number	001

EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Money purchase (other than target benefit)
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

21 PLUS, INC. has sponsored the creation of one or more 401k plans.

Company Name: 21 PLUS, INC.

Employer identification number (EIN): 222286760

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 JOANNE HANSON 2023-07-19
001 2021-01-01 JOANNE HANSON 2022-04-20
001 2020-01-01 JOANNE HANSON 2021-04-28
001 2020-01-01 JOANNE HANSON 2021-04-27
001 2019-01-01 JOANNE HANSON 2020-10-07
001 2018-01-01 DONNA MATOZZI 2019-10-11
001 2017-01-01 DONNA MATOZZI 2018-10-08 DIANE HUTTON-ROSE 2018-10-08
001 2016-01-01 DONNA MATOZZI 2017-07-28 DAVID VELARDO 2017-07-28
001 2015-01-01 MARY NORMAN 2016-07-29 SHEILA MELORE 2016-07-29
001 2014-01-01 MARY NORMAN 2015-10-15 SHEILA MELORE 2015-10-15
001 2013-01-01 MARY NORMAN 2014-07-30 SHEILA MELORE 2014-07-31
001 2012-01-01 MARY NORMAN SHEILA MELORE 2013-07-25
001 2011-01-01 MARY NORMAN SHEILA MELORE 2012-07-30
001 2009-01-01 MARY NORMAN SHEILA MELORE 2010-10-05

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	JOANNE HANSON	2023-07-19
001	2021-01-01	JOANNE HANSON	2022-04-20
001	2020-01-01	JOANNE HANSON	2021-04-28
001	2020-01-01	JOANNE HANSON	2021-04-27
001	2019-01-01	JOANNE HANSON	2020-10-07
001	2018-01-01	DONNA MATOZZI	2019-10-11
001	2017-01-01	DONNA MATOZZI	2018-10-08	DIANE HUTTON-ROSE	2018-10-08
001	2016-01-01	DONNA MATOZZI	2017-07-28	DAVID VELARDO	2017-07-28
001	2015-01-01	MARY NORMAN	2016-07-29	SHEILA MELORE	2016-07-29
001	2014-01-01	MARY NORMAN	2015-10-15	SHEILA MELORE	2015-10-15
001	2013-01-01	MARY NORMAN	2014-07-30	SHEILA MELORE	2014-07-31
001	2012-01-01	MARY NORMAN		SHEILA MELORE	2013-07-25
001	2011-01-01	MARY NORMAN		SHEILA MELORE	2012-07-30
001	2009-01-01	MARY NORMAN		SHEILA MELORE	2010-10-05

Plan Statistics for EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC.

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC.

Measure Date Value
2012: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 13
Number of other retired or separated participants entitled to future benefits 2012-01-01 9
Total of all active and inactive participants 2012-01-01 22
Total participants 2012-01-01 22
2011: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 9
Number of other retired or separated participants entitled to future benefits 2011-01-01 8
Total of all active and inactive participants 2011-01-01 17
Total participants 2011-01-01 17
Number of participants with account balances 2011-01-01 17
2009: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 10
Number of other retired or separated participants entitled to future benefits 2009-01-01 8
Total of all active and inactive participants 2009-01-01 18
Total participants 2009-01-01 18
Number of participants with account balances 2009-01-01 18

Measure	Date	Value
2012: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	13
Number of other retired or separated participants entitled to future benefits	2012-01-01	9
Total of all active and inactive participants	2012-01-01	22
Total participants	2012-01-01	22
2011: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	9
Number of other retired or separated participants entitled to future benefits	2011-01-01	8
Total of all active and inactive participants	2011-01-01	17
Total participants	2011-01-01	17
Number of participants with account balances	2011-01-01	17
2009: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	10
Number of other retired or separated participants entitled to future benefits	2009-01-01	8
Total of all active and inactive participants	2009-01-01	18
Total participants	2009-01-01	18
Number of participants with account balances	2009-01-01	18

Financial Data on EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC.

Measure	Date	Value
2012 : EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2012 401k financial data
Total income from all sources	2012-12-31	$49,147
Expenses. Total of all expenses incurred	2012-12-31	$2,508
Total plan assets at end of year	2012-12-31	$408,614
Total plan assets at beginning of year	2012-12-31	$361,975
Value of fidelity bond covering the plan	2012-12-31	$48,800
Expenses. Other expenses not covered elsewhere	2012-12-31	$2,508
Contributions received from other sources (not participants or employers)	2012-12-31	$2,118
Other income received	2012-12-31	$19,769
Net income (gross income less expenses)	2012-12-31	$46,639
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$408,614
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$361,975
Total contributions received or receivable from employer(s)	2012-12-31	$27,260
2011 : EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2011 401k financial data
Total income from all sources	2011-12-31	$14,640
Expenses. Total of all expenses incurred	2011-12-31	$288
Total plan assets at end of year	2011-12-31	$361,975
Total plan assets at beginning of year	2011-12-31	$347,623
Value of fidelity bond covering the plan	2011-12-31	$80,000
Expenses. Other expenses not covered elsewhere	2011-12-31	$288
Other income received	2011-12-31	$-5,942
Net income (gross income less expenses)	2011-12-31	$14,352
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$361,975
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$347,623
Total contributions received or receivable from employer(s)	2011-12-31	$20,582
2010 : EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2010 401k financial data
Total income from all sources	2010-12-31	$40,458
Expenses. Total of all expenses incurred	2010-12-31	$2,002
Total plan assets at end of year	2010-12-31	$347,623
Total plan assets at beginning of year	2010-12-31	$309,167
Value of fidelity bond covering the plan	2010-12-31	$100,000
Expenses. Other expenses not covered elsewhere	2010-12-31	$2,002
Contributions received from other sources (not participants or employers)	2010-12-31	$1,471
Other income received	2010-12-31	$17,014
Net income (gross income less expenses)	2010-12-31	$38,456
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$347,623
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$309,167
Total contributions received or receivable from employer(s)	2010-12-31	$21,973
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC.

2012: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

053542-D

Policy instance

Insurance contract or identification number	053542-D
Number of Individuals Covered	22
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of fees paid to insurance company	USD $53
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	7
Additional information about fees paid to insurance broker	COMPENSATION
Insurance broker organization code?	3
Insurance broker name	MICHAEL J. SCOTT

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

053542-D

Policy instance

Insurance contract or identification number	053542-D
Number of Individuals Covered	17
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $83
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

053542-D-03

Policy instance

Insurance contract or identification number	053542-D-03
Number of Individuals Covered	17
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of fees paid to insurance company	USD $23
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	2
Additional information about fees paid to insurance broker	COMPENSATION
Insurance broker organization code?	3
Insurance broker name	MICHAEL J. SCOTT

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Company Name:	21 PLUS, INC.
Employer identification number (EIN):	222286760
NAIC Classification:	624100
NAIC Description:	Individual and Family Services