| Plan Name | HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GUYS FLOOR SERVICE INC. |
| Employer identification number (EIN): | 840400179 |
| NAIC Classification: | 236200 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-07-01 | CHRISTINA STEPHENS | 2024-10-25 |
| Measure | Date | Value |
|---|---|---|
| 2023: HEALTH AND WELFARE PLAN 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-07-01 | 156 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-07-01 | 133 |
| Number of retired or separated participants receiving benefits | 2023-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-07-01 | 0 |
| Total of all active and inactive participants | 2023-07-01 | 133 |
| Number of employers contributing to the scheme | 2023-07-01 | 0 |
| 2023: HEALTH AND WELFARE PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-07-01 | Type of plan entity | Single employer plan |
| 2023-07-01 | First time form 5500 has been submitted | Yes |
| 2023-07-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2023-07-01 | Plan funding arrangement – Insurance | Yes |
| 2023-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 195232 | ||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 939667 | ||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||
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