401k Plan data: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN plan

WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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

WESTERN BEEF RETAIL, INC has sponsored the creation of one or more 401k plans.

Company Name: WESTERN BEEF RETAIL, INC

Employer identification number (EIN): 112778081

NAIC Classification: 445110
NAIC Description: Supermarkets and Other Grocery (except Convenience) Stores

Additional information about WESTERN BEEF RETAIL, INC

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1985-12-16

Company Identification Number: 1028843

Legal Registered Office Address: 47-05 Metropolitan Ave
ATTN LEGAL DEPARTMENT
Ridgewood
United States of America (USA)
11385

More information about WESTERN BEEF RETAIL, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01

Plan Statistics for WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,507
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,265
Number of retired or separated participants receiving benefits 2022-01-01 148
Number of other retired or separated participants entitled to future benefits 2022-01-01 91
Total of all active and inactive participants 2022-01-01 1,504
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 1,504
Number of participants with account balances 2022-01-01 1,000
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 33
2021: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,580
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,116
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 1
Total of all active and inactive participants 2021-01-01 1,117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 1,117
Number of participants with account balances 2021-01-01 201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 15
2020: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 2,083
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,902
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 552
Total of all active and inactive participants 2020-01-01 2,454
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 2,455
Number of participants with account balances 2020-01-01 1,649
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 100

Measure	Date	Value
2022: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,507
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,265
Number of retired or separated participants receiving benefits	2022-01-01	148
Number of other retired or separated participants entitled to future benefits	2022-01-01	91
Total of all active and inactive participants	2022-01-01	1,504
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	1,504
Number of participants with account balances	2022-01-01	1,000
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	33
2021: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,580
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,116
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	1
Total of all active and inactive participants	2021-01-01	1,117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	1,117
Number of participants with account balances	2021-01-01	201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	15
2020: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	2,083
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,902
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	552
Total of all active and inactive participants	2020-01-01	2,454
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	2,455
Number of participants with account balances	2020-01-01	1,649
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	100

Financial Data on WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2022 : WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$49,821
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$36,712
Total income from all sources (including contributions)	2022-12-31	$-2,122,941
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$3,645,587
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$3,379,704
Expenses. Certain deemed distributions of participant loans	2022-12-31	$210,924
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,711,639
Value of total assets at end of year	2022-12-31	$22,810,149
Value of total assets at beginning of year	2022-12-31	$28,565,568
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$54,959
Total interest from all sources	2022-12-31	$67,109
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$1,013,905
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$1,013,905
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,120,352
Participant contributions at end of year	2022-12-31	$1,089,673
Participant contributions at beginning of year	2022-12-31	$1,214,752
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$295,559
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$24
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$392
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$49,821
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$36,712
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Income. Non cash contributions	2022-12-31	$24
Value of net income/loss	2022-12-31	$-5,768,528
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$22,760,328
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$28,528,856
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$20,647,084
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$26,516,059
Interest on participant loans	2022-12-31	$62,801
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$769,241
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$469,857
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$469,857
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$4,308
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-4,915,594
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$295,704
Employer contributions (assets) at end of year	2022-12-31	$304,127
Employer contributions (assets) at beginning of year	2022-12-31	$364,508
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$3,379,704
Contract administrator fees	2022-12-31	$54,959
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	PLANCHEC(K) CPAS
Accountancy firm EIN	2022-12-31	842614035
2021 : WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$36,712
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$38,566
Total income from all sources (including contributions)	2021-12-31	$5,093,936
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$2,278,426
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,920,433
Expenses. Certain deemed distributions of participant loans	2021-12-31	$220,225
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,553,398
Value of total assets at end of year	2021-12-31	$28,565,568
Value of total assets at beginning of year	2021-12-31	$25,751,912
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$137,768
Total interest from all sources	2021-12-31	$96,186
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$1,469,054
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$1,469,054
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,186,662
Participant contributions at end of year	2021-12-31	$1,214,752
Participant contributions at beginning of year	2021-12-31	$1,426,109
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$22,998
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$2,228
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$392
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$178
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$36,712
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$38,566
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$2,815,510
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$28,528,856
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$25,713,346
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$137,768
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$26,516,059
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$22,057,140
Interest on participant loans	2021-12-31	$94,439
Value of interest in common/collective trusts at end of year	2021-12-31	$469,857
Value of interest in common/collective trusts at beginning of year	2021-12-31	$2,153,681
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$1,747
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,975,298
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$364,508
Employer contributions (assets) at end of year	2021-12-31	$364,508
Employer contributions (assets) at beginning of year	2021-12-31	$91,806
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,920,433
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	PLANCHEC(K) CPAS
Accountancy firm EIN	2021-12-31	842614035
2020 : WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$38,566
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$55,037
Total income from all sources (including contributions)	2020-12-31	$4,717,603
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$4,043,805
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$3,607,092
Expenses. Certain deemed distributions of participant loans	2020-12-31	$144,141
Value of total corrective distributions	2020-12-31	$55,037
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,594,872
Value of total assets at end of year	2020-12-31	$25,751,912
Value of total assets at beginning of year	2020-12-31	$25,094,585
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$237,535
Total interest from all sources	2020-12-31	$138,101
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$17,838
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$1,230,057
Participant contributions at end of year	2020-12-31	$1,426,109
Participant contributions at beginning of year	2020-12-31	$1,610,102
Participant contributions at end of year	2020-12-31	$22,998
Participant contributions at beginning of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$273,009
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$178
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$38,566
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$55,037
Liabilities. Value of operating payables at end of year	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$673,798
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$25,713,346
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$25,039,548
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$219,697
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$22,057,140
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$21,672,756
Value of interest in pooled separate accounts at end of year	2020-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$0
Interest on participant loans	2020-12-31	$82,783
Value of interest in master investment trust accounts at end of year	2020-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2020-12-31	$0
Value of interest in common/collective trusts at end of year	2020-12-31	$2,153,681
Value of interest in common/collective trusts at beginning of year	2020-12-31	$1,811,727
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$55,318
Assets. Value of investments in 103.12 investment entities at end of year	2020-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$2,984,630
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$91,806
Employer contributions (assets) at end of year	2020-12-31	$91,806
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$3,607,092
Liabilities. Value of benefit claims payable at end of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	PLANCHEC(K) CPAS
Accountancy firm EIN	2020-12-31	842614035

Form 5500 Responses for WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN

2022: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-HU2F

Policy instance

Insurance contract or identification number	GAP-CP-HU2F
Number of Individuals Covered	643
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-HU2F

Policy instance

Insurance contract or identification number	GAP-CP-HU2F
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

590699-01

Policy instance

Insurance contract or identification number	590699-01
Number of Individuals Covered	806
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-CP-HU2F

Policy instance

Insurance contract or identification number	GAP-CP-HU2F
Number of Individuals Covered	1649
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

WESTERN BEEF, INC. 401(K) PROFIT SHARING PLAN [EIN = 133266114]

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Company Name:	WESTERN BEEF RETAIL, INC
Employer identification number (EIN):	112778081
NAIC Classification:	445110
NAIC Description:	Supermarkets and Other Grocery (except Convenience) Stores

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1985-12-16
Company Identification Number:	1028843
Legal Registered Office Address:	47-05 Metropolitan Ave ATTN LEGAL DEPARTMENT Ridgewood United States of America (USA) 11385