401k Plan data: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN plan

DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 401k Plan overview

Plan Name	DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN
Plan identification number	502

DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Other welfare benefit cover

401k Sponsoring company profile

DREW FOAM COMPANIES, INC. has sponsored the creation of one or more 401k plans.

Company Name: DREW FOAM COMPANIES, INC.

Employer identification number (EIN): 205955180

NAIC Classification: 326100

Additional information about DREW FOAM COMPANIES, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 4252175

More information about DREW FOAM COMPANIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2019-01-01 JOANNA BERGERON 2020-10-15 JOANNA BERGERON 2020-10-15
502 2019-01-01 DAVID ZIPSE 2020-12-28 DAVID ZIPSE 2020-12-28
502 2018-01-01 DAVID ZIPSE 2019-10-14
502 2017-01-01 HOGANTAYLOR LLP PREPARER
502 2016-01-01
502 2015-01-01
502 2014-01-01
502 2013-01-01
502 2012-01-01 SUSAN MCCLENDON
502 2011-01-01 SUSAN MCCLENDON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2019-01-01	JOANNA BERGERON	2020-10-15	JOANNA BERGERON	2020-10-15
502	2019-01-01	DAVID ZIPSE	2020-12-28	DAVID ZIPSE	2020-12-28
502	2018-01-01	DAVID ZIPSE	2019-10-14
502	2017-01-01	HOGANTAYLOR LLP PREPARER
502	2016-01-01
502	2015-01-01
502	2014-01-01
502	2013-01-01
502	2012-01-01	SUSAN MCCLENDON
502	2011-01-01	SUSAN MCCLENDON

Plan Statistics for DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN

401k plan membership statisitcs for DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN

Measure Date Value
2019: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 209
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 209
Total of all active and inactive participants 2019-01-01 209
2018: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 178
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 209
Total of all active and inactive participants 2018-01-01 209
2017: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 172
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 178
Total of all active and inactive participants 2017-01-01 178
Total participants 2017-01-01 178
2016: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 163
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 172
Total of all active and inactive participants 2016-01-01 172
2015: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 200
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 163
Total of all active and inactive participants 2015-01-01 163
2014: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 200
Total of all active and inactive participants 2014-01-01 200
2013: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 124
Total of all active and inactive participants 2013-01-01 124
2012: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 133
Total of all active and inactive participants 2012-01-01 133
2011: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 270
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 133
Total of all active and inactive participants 2011-01-01 133

Measure	Date	Value
2019: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	209
Total of all active and inactive participants	2019-01-01	209
2018: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	178
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	209
Total of all active and inactive participants	2018-01-01	209
2017: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	172
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	178
Total of all active and inactive participants	2017-01-01	178
Total participants	2017-01-01	178
2016: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	163
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	172
Total of all active and inactive participants	2016-01-01	172
2015: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	200
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	163
Total of all active and inactive participants	2015-01-01	163
2014: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	200
Total of all active and inactive participants	2014-01-01	200
2013: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	124
Total of all active and inactive participants	2013-01-01	124
2012: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	133
Total of all active and inactive participants	2012-01-01	133
2011: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	270
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	133
Total of all active and inactive participants	2011-01-01	133

Form 5500 Responses for DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN

2019: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 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: DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN 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

Insurance Providers Used on plan

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50001199

Policy instance

Insurance contract or identification number	50001199
Number of Individuals Covered	209
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $192
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $11,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $164
Insurance broker organization code?	3

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50001199

Policy instance

Insurance contract or identification number	50001199
Number of Individuals Covered	178
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $188
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $10,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $163
Insurance broker organization code?	3
Insurance broker name	CHRISTOPHER SHUMAKE

Potentially related plans

DREW FOAM COMPANIES, INC. LIFE AND AD&D PLAN [EIN = 710511719]

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Company Name:	DREW FOAM COMPANIES, INC.
Employer identification number (EIN):	205955180
NAIC Classification:	326100

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	4252175