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MEDICAL, EPO, DENTAL, VISION, DRUG 401k Plan overview

Plan NameMEDICAL, EPO, DENTAL, VISION, DRUG
Plan identification number 501

MEDICAL, EPO, DENTAL, VISION, DRUG Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

RUTTER'S has sponsored the creation of one or more 401k plans.

Company Name:RUTTER'S
Employer identification number (EIN):231331865
NAIC Classification:445120
NAIC Description:Convenience Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL, EPO, DENTAL, VISION, DRUG

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-12-01SCOTT HARTMAN2019-06-06
5012016-12-01
5012015-12-01
5012014-12-01
5012013-12-01SCOTT E. HARTMAN
5012012-12-01SCOTT HARTMAN
5012011-12-01SCOTT HARTMAN
5012009-12-01SCOTT E HARTMAN
5012008-12-01SCOTT E HARTMAN

Plan Statistics for MEDICAL, EPO, DENTAL, VISION, DRUG

401k plan membership statisitcs for MEDICAL, EPO, DENTAL, VISION, DRUG

Measure Date Value
2017: MEDICAL, EPO, DENTAL, VISION, DRUG 2017 401k membership
Total participants, beginning-of-year2017-12-01431
Total number of active participants reported on line 7a of the Form 55002017-12-010
Number of retired or separated participants receiving benefits2017-12-010
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-010
Number of employers contributing to the scheme2017-12-010
2016: MEDICAL, EPO, DENTAL, VISION, DRUG 2016 401k membership
Total participants, beginning-of-year2016-12-01365
Total number of active participants reported on line 7a of the Form 55002016-12-01428
Number of retired or separated participants receiving benefits2016-12-013
Total of all active and inactive participants2016-12-01431
2015: MEDICAL, EPO, DENTAL, VISION, DRUG 2015 401k membership
Total participants, beginning-of-year2015-12-01401
Total number of active participants reported on line 7a of the Form 55002015-12-01360
Number of retired or separated participants receiving benefits2015-12-013
Number of other retired or separated participants entitled to future benefits2015-12-012
Total of all active and inactive participants2015-12-01365
2014: MEDICAL, EPO, DENTAL, VISION, DRUG 2014 401k membership
Total participants, beginning-of-year2014-12-01408
Total number of active participants reported on line 7a of the Form 55002014-12-01391
Number of retired or separated participants receiving benefits2014-12-015
Number of other retired or separated participants entitled to future benefits2014-12-015
Total of all active and inactive participants2014-12-01401
2013: MEDICAL, EPO, DENTAL, VISION, DRUG 2013 401k membership
Total participants, beginning-of-year2013-12-01443
Total number of active participants reported on line 7a of the Form 55002013-12-01393
Number of retired or separated participants receiving benefits2013-12-0115
Number of other retired or separated participants entitled to future benefits2013-12-010
Total of all active and inactive participants2013-12-01408
2012: MEDICAL, EPO, DENTAL, VISION, DRUG 2012 401k membership
Total participants, beginning-of-year2012-12-01431
Total number of active participants reported on line 7a of the Form 55002012-12-01387
Number of retired or separated participants receiving benefits2012-12-0116
Number of other retired or separated participants entitled to future benefits2012-12-010
Total of all active and inactive participants2012-12-01403
2011: MEDICAL, EPO, DENTAL, VISION, DRUG 2011 401k membership
Total participants, beginning-of-year2011-12-01409
Total number of active participants reported on line 7a of the Form 55002011-12-01390
Number of retired or separated participants receiving benefits2011-12-0110
Number of other retired or separated participants entitled to future benefits2011-12-010
Total of all active and inactive participants2011-12-01400
2009: MEDICAL, EPO, DENTAL, VISION, DRUG 2009 401k membership
Total participants, beginning-of-year2009-12-01396
Total number of active participants reported on line 7a of the Form 55002009-12-01322
Number of retired or separated participants receiving benefits2009-12-010
Number of other retired or separated participants entitled to future benefits2009-12-010
Total of all active and inactive participants2009-12-01322
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-12-010
Total participants2009-12-01322
Number of participants with account balances2009-12-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-12-010
2008: MEDICAL, EPO, DENTAL, VISION, DRUG 2008 401k membership
Total participants, beginning-of-year2008-12-01322
Total number of active participants reported on line 7a of the Form 55002008-12-01396
Number of retired or separated participants receiving benefits2008-12-010
Number of other retired or separated participants entitled to future benefits2008-12-010
Total of all active and inactive participants2008-12-01396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-12-010
Total participants2008-12-01396
Number of participants with account balances2008-12-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2008-12-010

Form 5500 Responses for MEDICAL, EPO, DENTAL, VISION, DRUG

2017: MEDICAL, EPO, DENTAL, VISION, DRUG 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01This submission is the final filingYes
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan funding arrangement – General assets of the sponsorYes
2017-12-01Plan benefit arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – General assets of the sponsorYes
2016: MEDICAL, EPO, DENTAL, VISION, DRUG 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan funding arrangement – General assets of the sponsorYes
2016-12-01Plan benefit arrangement – InsuranceYes
2016-12-01Plan benefit arrangement – General assets of the sponsorYes
2015: MEDICAL, EPO, DENTAL, VISION, DRUG 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan funding arrangement – General assets of the sponsorYes
2015-12-01Plan benefit arrangement – InsuranceYes
2015-12-01Plan benefit arrangement – General assets of the sponsorYes
2014: MEDICAL, EPO, DENTAL, VISION, DRUG 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan funding arrangement – General assets of the sponsorYes
2014-12-01Plan benefit arrangement – InsuranceYes
2014-12-01Plan benefit arrangement – General assets of the sponsorYes
2013: MEDICAL, EPO, DENTAL, VISION, DRUG 2013 form 5500 responses
2013-12-01Type of plan entitySingle employer plan
2013-12-01Submission has been amendedNo
2013-12-01This submission is the final filingNo
2013-12-01This return/report is a short plan year return/report (less than 12 months)No
2013-12-01Plan is a collectively bargained planNo
2013-12-01Plan funding arrangement – InsuranceYes
2013-12-01Plan funding arrangement – General assets of the sponsorYes
2013-12-01Plan benefit arrangement – InsuranceYes
2013-12-01Plan benefit arrangement – General assets of the sponsorYes
2012: MEDICAL, EPO, DENTAL, VISION, DRUG 2012 form 5500 responses
2012-12-01Type of plan entitySingle employer plan
2012-12-01Submission has been amendedNo
2012-12-01This submission is the final filingNo
2012-12-01This return/report is a short plan year return/report (less than 12 months)No
2012-12-01Plan is a collectively bargained planNo
2012-12-01Plan funding arrangement – InsuranceYes
2012-12-01Plan funding arrangement – General assets of the sponsorYes
2012-12-01Plan benefit arrangement – InsuranceYes
2012-12-01Plan benefit arrangement – General assets of the sponsorYes
2011: MEDICAL, EPO, DENTAL, VISION, DRUG 2011 form 5500 responses
2011-12-01Type of plan entitySingle employer plan
2011-12-01Submission has been amendedYes
2011-12-01This submission is the final filingNo
2011-12-01This return/report is a short plan year return/report (less than 12 months)No
2011-12-01Plan is a collectively bargained planNo
2011-12-01Plan funding arrangement – InsuranceYes
2011-12-01Plan funding arrangement – General assets of the sponsorYes
2011-12-01Plan benefit arrangement – InsuranceYes
2011-12-01Plan benefit arrangement – General assets of the sponsorYes
2009: MEDICAL, EPO, DENTAL, VISION, DRUG 2009 form 5500 responses
2009-12-01Type of plan entitySingle employer plan
2009-12-01Submission has been amendedYes
2009-12-01This submission is the final filingNo
2009-12-01This return/report is a short plan year return/report (less than 12 months)No
2009-12-01Plan is a collectively bargained planNo
2009-12-01Plan funding arrangement – InsuranceYes
2009-12-01Plan benefit arrangement – InsuranceYes
2008: MEDICAL, EPO, DENTAL, VISION, DRUG 2008 form 5500 responses
2008-12-01Type of plan entitySingle employer plan
2008-12-01Submission has been amendedNo
2008-12-01This submission is the final filingNo
2008-12-01This return/report is a short plan year return/report (less than 12 months)No
2008-12-01Plan is a collectively bargained planNo
2008-12-01Plan funding arrangement – InsuranceYes
2008-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number108486
Policy instance 1
Insurance contract or identification number108486
Number of Individuals Covered599
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $18,480
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,720,650
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2083
Policy instance 2
Insurance contract or identification number2083
Number of Individuals Covered334
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AVALON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12358 )
Policy contract number514150
Policy instance 3
Insurance contract or identification number514150
Number of Individuals Covered5
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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