401k Plan data: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE plan

FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 401k Plan overview

Plan Name	FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE
Plan identification number	501

FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE Benefits

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

401k Sponsoring company profile

FAIRFIELD CHAIR COMPANY has sponsored the creation of one or more 401k plans.

Company Name: FAIRFIELD CHAIR COMPANY

Employer identification number (EIN): 566067109

NAIC Classification: 337000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-02-01
501 2019-02-01 LORI THROWER 2020-08-13
501 2015-02-01 GARY RENEGAR
501 2014-02-01 GARY RENEGAR
501 2013-02-01 GARY RENEGAR
501 2012-02-01 GARY RENEGAR
501 2011-02-01 GARY RENEGAR
501 2010-02-01 GARY RENEGAR
501 2009-02-01 GARY RENEGAR

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2020-02-01
501	2019-02-01	LORI THROWER	2020-08-13
501	2015-02-01	GARY RENEGAR
501	2014-02-01	GARY RENEGAR
501	2013-02-01	GARY RENEGAR
501	2012-02-01	GARY RENEGAR
501	2011-02-01	GARY RENEGAR
501	2010-02-01	GARY RENEGAR
501	2009-02-01	GARY RENEGAR

Plan Statistics for FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE

401k plan membership statisitcs for FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE

Measure Date Value
2020: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2020 401k membership
Total participants, beginning-of-year 2020-02-01 406
Total number of active participants reported on line 7a of the Form 5500 2020-02-01 391
Number of retired or separated participants receiving benefits 2020-02-01 2
Number of other retired or separated participants entitled to future benefits 2020-02-01 12
Total of all active and inactive participants 2020-02-01 405
2019: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2019 401k membership
Total participants, beginning-of-year 2019-02-01 377
Total number of active participants reported on line 7a of the Form 5500 2019-02-01 406
Number of retired or separated participants receiving benefits 2019-02-01 0
Number of other retired or separated participants entitled to future benefits 2019-02-01 0
Total of all active and inactive participants 2019-02-01 406
Number of employers contributing to the scheme 2019-02-01 0
2015: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2015 401k membership
Total participants, beginning-of-year 2015-02-01 234
Total number of active participants reported on line 7a of the Form 5500 2015-02-01 251
Number of retired or separated participants receiving benefits 2015-02-01 3
Number of other retired or separated participants entitled to future benefits 2015-02-01 6
Total of all active and inactive participants 2015-02-01 260
2014: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2014 401k membership
Total participants, beginning-of-year 2014-02-01 215
Total number of active participants reported on line 7a of the Form 5500 2014-02-01 238
Number of retired or separated participants receiving benefits 2014-02-01 3
Number of other retired or separated participants entitled to future benefits 2014-02-01 24
Total of all active and inactive participants 2014-02-01 265
2013: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2013 401k membership
Total participants, beginning-of-year 2013-02-01 195
Total number of active participants reported on line 7a of the Form 5500 2013-02-01 215
Number of retired or separated participants receiving benefits 2013-02-01 1
Number of other retired or separated participants entitled to future benefits 2013-02-01 17
Total of all active and inactive participants 2013-02-01 233
2012: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2012 401k membership
Total participants, beginning-of-year 2012-02-01 180
Total number of active participants reported on line 7a of the Form 5500 2012-02-01 185
Number of retired or separated participants receiving benefits 2012-02-01 2
Number of other retired or separated participants entitled to future benefits 2012-02-01 9
Total of all active and inactive participants 2012-02-01 196
Number of employers contributing to the scheme 2012-02-01 374
2011: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2011 401k membership
Total participants, beginning-of-year 2011-02-01 202
Total number of active participants reported on line 7a of the Form 5500 2011-02-01 202
Number of retired or separated participants receiving benefits 2011-02-01 1
Number of other retired or separated participants entitled to future benefits 2011-02-01 3
Total of all active and inactive participants 2011-02-01 206
2010: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2010 401k membership
Total participants, beginning-of-year 2010-02-01 169
Total number of active participants reported on line 7a of the Form 5500 2010-02-01 201
Number of retired or separated participants receiving benefits 2010-02-01 1
Number of other retired or separated participants entitled to future benefits 2010-02-01 0
Total of all active and inactive participants 2010-02-01 202
2009: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2009 401k membership
Total participants, beginning-of-year 2009-02-01 182
Total number of active participants reported on line 7a of the Form 5500 2009-02-01 167
Number of retired or separated participants receiving benefits 2009-02-01 2
Number of other retired or separated participants entitled to future benefits 2009-02-01 0
Total of all active and inactive participants 2009-02-01 169

Measure	Date	Value
2020: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2020 401k membership
Total participants, beginning-of-year	2020-02-01	406
Total number of active participants reported on line 7a of the Form 5500	2020-02-01	391
Number of retired or separated participants receiving benefits	2020-02-01	2
Number of other retired or separated participants entitled to future benefits	2020-02-01	12
Total of all active and inactive participants	2020-02-01	405
2019: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2019 401k membership
Total participants, beginning-of-year	2019-02-01	377
Total number of active participants reported on line 7a of the Form 5500	2019-02-01	406
Number of retired or separated participants receiving benefits	2019-02-01	0
Number of other retired or separated participants entitled to future benefits	2019-02-01	0
Total of all active and inactive participants	2019-02-01	406
Number of employers contributing to the scheme	2019-02-01	0
2015: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2015 401k membership
Total participants, beginning-of-year	2015-02-01	234
Total number of active participants reported on line 7a of the Form 5500	2015-02-01	251
Number of retired or separated participants receiving benefits	2015-02-01	3
Number of other retired or separated participants entitled to future benefits	2015-02-01	6
Total of all active and inactive participants	2015-02-01	260
2014: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2014 401k membership
Total participants, beginning-of-year	2014-02-01	215
Total number of active participants reported on line 7a of the Form 5500	2014-02-01	238
Number of retired or separated participants receiving benefits	2014-02-01	3
Number of other retired or separated participants entitled to future benefits	2014-02-01	24
Total of all active and inactive participants	2014-02-01	265
2013: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2013 401k membership
Total participants, beginning-of-year	2013-02-01	195
Total number of active participants reported on line 7a of the Form 5500	2013-02-01	215
Number of retired or separated participants receiving benefits	2013-02-01	1
Number of other retired or separated participants entitled to future benefits	2013-02-01	17
Total of all active and inactive participants	2013-02-01	233
2012: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2012 401k membership
Total participants, beginning-of-year	2012-02-01	180
Total number of active participants reported on line 7a of the Form 5500	2012-02-01	185
Number of retired or separated participants receiving benefits	2012-02-01	2
Number of other retired or separated participants entitled to future benefits	2012-02-01	9
Total of all active and inactive participants	2012-02-01	196
Number of employers contributing to the scheme	2012-02-01	374
2011: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2011 401k membership
Total participants, beginning-of-year	2011-02-01	202
Total number of active participants reported on line 7a of the Form 5500	2011-02-01	202
Number of retired or separated participants receiving benefits	2011-02-01	1
Number of other retired or separated participants entitled to future benefits	2011-02-01	3
Total of all active and inactive participants	2011-02-01	206
2010: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2010 401k membership
Total participants, beginning-of-year	2010-02-01	169
Total number of active participants reported on line 7a of the Form 5500	2010-02-01	201
Number of retired or separated participants receiving benefits	2010-02-01	1
Number of other retired or separated participants entitled to future benefits	2010-02-01	0
Total of all active and inactive participants	2010-02-01	202
2009: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2009 401k membership
Total participants, beginning-of-year	2009-02-01	182
Total number of active participants reported on line 7a of the Form 5500	2009-02-01	167
Number of retired or separated participants receiving benefits	2009-02-01	2
Number of other retired or separated participants entitled to future benefits	2009-02-01	0
Total of all active and inactive participants	2009-02-01	169

Form 5500 Responses for FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE

2020: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2020 form 5500 responses
2020-02-01	Type of plan entity	Single employer plan
2020-02-01	Submission has been amended	No
2020-02-01	This submission is the final filing	No
2020-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-02-01	Plan is a collectively bargained plan	No
2020-02-01	Plan funding arrangement – Insurance	Yes
2020-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-02-01	Plan benefit arrangement – Insurance	Yes
2020-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2019 form 5500 responses
2019-02-01	Type of plan entity	Single employer plan
2019-02-01	Plan funding arrangement – Insurance	Yes
2019-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-02-01	Plan benefit arrangement – Insurance	Yes
2019-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2015 form 5500 responses
2015-02-01	Type of plan entity	Single employer plan
2015-02-01	Submission has been amended	No
2015-02-01	This submission is the final filing	No
2015-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-02-01	Plan is a collectively bargained plan	No
2015-02-01	Plan funding arrangement – Insurance	Yes
2015-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-02-01	Plan benefit arrangement – Insurance	Yes
2015-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2014 form 5500 responses
2014-02-01	Type of plan entity	Single employer plan
2014-02-01	Submission has been amended	No
2014-02-01	This submission is the final filing	No
2014-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-02-01	Plan is a collectively bargained plan	No
2014-02-01	Plan funding arrangement – Insurance	Yes
2014-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-02-01	Plan benefit arrangement – Insurance	Yes
2014-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2013 form 5500 responses
2013-02-01	Type of plan entity	Single employer plan
2013-02-01	Submission has been amended	No
2013-02-01	This submission is the final filing	No
2013-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-02-01	Plan is a collectively bargained plan	No
2013-02-01	Plan funding arrangement – Insurance	Yes
2013-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-02-01	Plan benefit arrangement – Insurance	Yes
2013-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2012 form 5500 responses
2012-02-01	Type of plan entity	Single employer plan
2012-02-01	Submission has been amended	No
2012-02-01	This submission is the final filing	No
2012-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-02-01	Plan is a collectively bargained plan	No
2012-02-01	Plan funding arrangement – Insurance	Yes
2012-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-02-01	Plan benefit arrangement – Insurance	Yes
2012-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2011 form 5500 responses
2011-02-01	Type of plan entity	Single employer plan
2011-02-01	Submission has been amended	No
2011-02-01	This submission is the final filing	No
2011-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-02-01	Plan is a collectively bargained plan	No
2011-02-01	Plan funding arrangement – Insurance	Yes
2011-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-02-01	Plan benefit arrangement – Insurance	Yes
2011-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2010 form 5500 responses
2010-02-01	Type of plan entity	Single employer plan
2010-02-01	Submission has been amended	No
2010-02-01	This submission is the final filing	No
2010-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-02-01	Plan is a collectively bargained plan	No
2010-02-01	Plan funding arrangement – Insurance	Yes
2010-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-02-01	Plan benefit arrangement – Insurance	Yes
2010-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: FAIRFIELD CHAIR EMPLOYEE GROUP MEDICAL INSURANCE 2009 form 5500 responses
2009-02-01	Type of plan entity	Single employer plan
2009-02-01	Submission has been amended	No
2009-02-01	This submission is the final filing	No
2009-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-02-01	Plan is a collectively bargained plan	No
2009-02-01	Plan funding arrangement – Insurance	Yes
2009-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-02-01	Plan benefit arrangement – Insurance	Yes
2009-02-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number	743731
Policy instance	6
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract number	G00613629
Policy instance	2
COMMUNITY EYE CARE (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number	TP035012
Policy instance	1
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number	0444500000
Policy instance	3
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number	0444500000
Policy instance	4
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number	0444500000
Policy instance	5
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract number	G00613629
Policy instance	2
COMMUNITY EYE CARE (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number	TP035012
Policy instance	3
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number	0444500000
Policy instance	5
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number	0444500000
Policy instance	6
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number	743731
Policy instance	1
TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )
Policy contract number	0444500000
Policy instance	4
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number	048448
Policy instance	3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract number	G 00613629
Policy instance	2
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract number	G 00613629
Policy instance	1
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number	048448
Policy instance	3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50001496
Policy instance	2
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50001496
Policy instance	1
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50001496
Policy instance	3
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number	048448
Policy instance	2
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50001496
Policy instance	1
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50001496
Policy instance	1
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number	048448
Policy instance	3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50001496
Policy instance	2
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number	048448
Policy instance	2
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50001496
Policy instance	1
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number	50001496
Policy instance	2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000721
Policy instance	1
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number	048448
Policy instance	3

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Company Name:	FAIRFIELD CHAIR COMPANY
Employer identification number (EIN):	566067109
NAIC Classification:	337000