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| Plan Name | HMSA MEDICAL PLAN FOR EMPLOYEES OF PACIFIC FOOD SERVICES, INC |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PACIFIC FOOD SERVICES, INC |
| Employer identification number (EIN): | 990112860 |
| NAIC Classification: | 722300 |
| NAIC Description: | Special Food Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2011-01-01 | MARIAN WONG | |||
| 501 | 2009-01-01 | MARIAN WONG | 2010-07-13 |
| Measure | Date | Value |
|---|---|---|
| 2011: HMSA MEDICAL PLAN FOR EMPLOYEES OF PACIFIC FOOD SERVICES, INC 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 9 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 8 |
| Total of all active and inactive participants | 2011-01-01 | 8 |
| Total participants | 2011-01-01 | 8 |
| Number of participants with account balances | 2011-01-01 | 8 |
| 2009: HMSA MEDICAL PLAN FOR EMPLOYEES OF PACIFIC FOOD SERVICES, INC 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 8 |
| Total of all active and inactive participants | 2009-01-01 | 8 |
| Total participants | 2009-01-01 | 8 |
| Number of participants with account balances | 2009-01-01 | 8 |
| Measure | Date | Value |
|---|---|---|
| 2011 : HMSA MEDICAL PLAN FOR EMPLOYEES OF PACIFIC FOOD SERVICES, INC 2011 401k financial data | ||
| Total income from all sources | 2011-12-31 | $42,912 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $42,912 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $42,912 |
| Total contributions received or receivable from participants | 2011-12-31 | $27,038 |
| Net income (gross income less expenses) | 2011-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $15,874 |
| 2010 : HMSA MEDICAL PLAN FOR EMPLOYEES OF PACIFIC FOOD SERVICES, INC 2010 401k financial data | ||
| Total income from all sources | 2010-12-31 | $42,228 |
| Total contributions received or receivable from participants | 2010-12-31 | $18,923 |
| Net income (gross income less expenses) | 2010-12-31 | $42,228 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $23,305 |
| 2011: HMSA MEDICAL PLAN FOR EMPLOYEES OF PACIFIC FOOD SERVICES, INC 2011 form 5500 responses | ||
|---|---|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: HMSA MEDICAL PLAN FOR EMPLOYEES OF PACIFIC FOOD SERVICES, INC 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
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