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ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 401k Plan overview

Plan NameACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD.
Plan identification number 501

ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

KARNS PRIME & FANCY FOOD, LTD. has sponsored the creation of one or more 401k plans.

Company Name:KARNS PRIME & FANCY FOOD, LTD.
Employer identification number (EIN):231930040
NAIC Classification:445110
NAIC Description:Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01JOSHUA KARNS
5012016-01-01JOSHUA KARNS JOSHUA KARNS2017-07-25
5012015-01-01JOSHUA KARNS JOSHUA KARNS2016-09-21
5012014-01-01JOSHUA KARNS JOSHUA KARNS2015-10-09
5012013-01-01JOSHUA KARNS JOSHUA KARNS2014-10-13
5012012-01-01D. SCOTT KARNS D. SCOTT KARNS2013-07-19
5012011-01-01D. SCOTT KARNS D. SCOTT KARNS2012-10-11
5012010-01-01D. SCOTT KARNS D. SCOTT KARNS2011-10-17
5012009-01-01D SCOTT KARNS

Plan Statistics for ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD.

401k plan membership statisitcs for ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD.

Measure Date Value
2017: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2017 401k membership
Total participants, beginning-of-year2017-01-01298
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
2016: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2016 401k membership
Total participants, beginning-of-year2016-01-01294
Total number of active participants reported on line 7a of the Form 55002016-01-01298
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01298
2015: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2015 401k membership
Total participants, beginning-of-year2015-01-01293
Total number of active participants reported on line 7a of the Form 55002015-01-01294
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01294
2014: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2014 401k membership
Total participants, beginning-of-year2014-01-01291
Total number of active participants reported on line 7a of the Form 55002014-01-01293
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01293
2013: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2013 401k membership
Total participants, beginning-of-year2013-01-01271
Total number of active participants reported on line 7a of the Form 55002013-01-01291
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01291
2012: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2012 401k membership
Total participants, beginning-of-year2012-01-01273
Total number of active participants reported on line 7a of the Form 55002012-01-01271
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01271
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01271
Number of participants with account balances2012-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2011 401k membership
Total participants, beginning-of-year2011-01-01287
Total number of active participants reported on line 7a of the Form 55002011-01-01273
Total of all active and inactive participants2011-01-01273
Total participants2011-01-01273
2010: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2010 401k membership
Total participants, beginning-of-year2010-01-01268
Total number of active participants reported on line 7a of the Form 55002010-01-01287
Total of all active and inactive participants2010-01-01287
Total participants2010-01-01287
2009: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2009 401k membership
Total participants, beginning-of-year2009-01-01261
Total number of active participants reported on line 7a of the Form 55002009-01-01268
Total of all active and inactive participants2009-01-01268
Total participants2009-01-01268

Form 5500 Responses for ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD.

2017: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: ACCIDENTIAL DEATH AND DISMEMBERMENT KARNS PRIME & FANCY FOOD LTD. 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5473446
Policy instance 1
Insurance contract or identification number5473446
Number of Individuals Covered269
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $16,989
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $119,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,989
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameCOMMONWEALTH FINANCIAL GROUP
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5473446
Policy instance 1
Insurance contract or identification number5473446
Number of Individuals Covered294
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $20,531
Total amount of fees paid to insurance companyUSD $4,826
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $117,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,531
Amount paid for insurance broker fees4826
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameCOMMONWEALTH FINANCIAL GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberZW413
Policy instance 1
Insurance contract or identification numberZW413
Number of Individuals Covered291
Insurance policy start date2013-12-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $2,299
Total amount of fees paid to insurance companyUSD $75
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $17,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,299
Amount paid for insurance broker fees75
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameCOMMONWEALTH FINANCIAL GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberZW413
Policy instance 1
Insurance contract or identification numberZW413
Number of Individuals Covered291
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $2,196
Total amount of fees paid to insurance companyUSD $70
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $17,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,196
Amount paid for insurance broker fees70
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameCOMMONWEALTH FINANCIAL GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberZW413
Policy instance 1
Insurance contract or identification numberZW413
Number of Individuals Covered271
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $2,080
Total amount of fees paid to insurance companyUSD $1,423
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $16,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,080
Amount paid for insurance broker fees1423
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameCOMMONWEALTH FINANCIAL GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberZW413
Policy instance 1
Insurance contract or identification numberZW413
Number of Individuals Covered273
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Total amount of commissions paid to insurance brokerUSD $1,631
Total amount of fees paid to insurance companyUSD $1,262
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $12,813
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberZW413
Policy instance 1
Insurance contract or identification numberZW413
Number of Individuals Covered287
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $1,545
Total amount of fees paid to insurance companyUSD $536
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $11,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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