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FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 401k Plan overview

Plan NameFAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN
Plan identification number 503

FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

FAIRVIEW EVERGREEN NURSERIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:FAIRVIEW EVERGREEN NURSERIES, INC.
Employer identification number (EIN):251095979
NAIC Classification:111400
NAIC Description:Greenhouse, Nursery, and Floriculture Production

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032020-02-01HAGAN HETZ2021-07-22 HAGAN HETZ2021-07-22
5032020-02-01HAGAN HETZ2023-01-26
5032019-02-01HAGAN HETZ2020-08-05 HAGAN HETZ2020-08-05
5032018-02-01HAGAN HETZ2019-07-23 HAGAN HETZ2019-07-23
5032017-02-01
5032016-02-01
5032015-02-01
5032014-02-01
5032013-02-01STEVEN J. KRITZMIRE STEVEN J. KRITZMIRE2014-10-14
5032012-02-01CHRISTINE HETZ PHILLIPS
5032011-02-01CHRISTINE HETZ PHILLIPS
5032010-02-01CHRISTINE HETZ PHILLIPS
5032009-02-01CHRISTINE HETZ PHILLIPS

Plan Statistics for FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN

401k plan membership statisitcs for FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN

Measure Date Value
2020: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-02-0199
Total number of active participants reported on line 7a of the Form 55002020-02-0199
Number of retired or separated participants receiving benefits2020-02-010
Number of other retired or separated participants entitled to future benefits2020-02-010
Total of all active and inactive participants2020-02-0199
Number of employers contributing to the scheme2020-02-010
2019: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-02-01103
Total number of active participants reported on line 7a of the Form 55002019-02-0199
Number of retired or separated participants receiving benefits2019-02-010
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-0199
2018: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-02-01101
Total number of active participants reported on line 7a of the Form 55002018-02-01103
Total of all active and inactive participants2018-02-01103
Total participants2018-02-01103
2017: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-02-01112
Total number of active participants reported on line 7a of the Form 55002017-02-01101
Total of all active and inactive participants2017-02-01101
Total participants2017-02-01101
2016: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-02-01115
Total number of active participants reported on line 7a of the Form 55002016-02-01112
Total of all active and inactive participants2016-02-01112
Total participants2016-02-01112
2015: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-02-01102
Total number of active participants reported on line 7a of the Form 55002015-02-01116
Total of all active and inactive participants2015-02-01116
Total participants2015-02-01116
2014: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-02-01102
Total number of active participants reported on line 7a of the Form 55002014-02-01102
Total of all active and inactive participants2014-02-01102
Total participants2014-02-01102
2013: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-02-0196
Total number of active participants reported on line 7a of the Form 55002013-02-01102
Total of all active and inactive participants2013-02-01102
Total participants2013-02-01102
2012: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-02-01103
Total number of active participants reported on line 7a of the Form 55002012-02-0196
Total of all active and inactive participants2012-02-0196
2011: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-02-01105
Total number of active participants reported on line 7a of the Form 55002011-02-01103
Total of all active and inactive participants2011-02-01103
2010: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-02-01113
Total number of active participants reported on line 7a of the Form 55002010-02-01105
Total of all active and inactive participants2010-02-01105
2009: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-02-01116
Total number of active participants reported on line 7a of the Form 55002009-02-01113
Number of retired or separated participants receiving benefits2009-02-010
Number of other retired or separated participants entitled to future benefits2009-02-010
Total of all active and inactive participants2009-02-01113

Form 5500 Responses for FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN

2020: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Submission has been amendedYes
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan benefit arrangement – InsuranceYes
2019: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan benefit arrangement – InsuranceYes
2018: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – InsuranceYes
2017: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – InsuranceYes
2015: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – InsuranceYes
2014: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan benefit arrangement – InsuranceYes
2013: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2013 form 5500 responses
2013-02-01Type of plan entitySingle employer plan
2013-02-01Plan funding arrangement – InsuranceYes
2013-02-01Plan benefit arrangement – InsuranceYes
2012: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2012 form 5500 responses
2012-02-01Type of plan entitySingle employer plan
2012-02-01Plan funding arrangement – InsuranceYes
2012-02-01Plan benefit arrangement – InsuranceYes
2011: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2011 form 5500 responses
2011-02-01Type of plan entitySingle employer plan
2011-02-01Plan funding arrangement – InsuranceYes
2011-02-01Plan benefit arrangement – InsuranceYes
2010: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2010 form 5500 responses
2010-02-01Type of plan entitySingle employer plan
2010-02-01Plan funding arrangement – InsuranceYes
2010-02-01Plan benefit arrangement – InsuranceYes
2009: FAIRVIEW EVERGREEN NURSERIES LIFE INSURANCE PLAN 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-01
Policy instance 2
Insurance contract or identification number01-015173-01
Number of Individuals Covered99
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $4,365
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,365
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-00
Policy instance 1
Insurance contract or identification number01-015173-00
Number of Individuals Covered99
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $2,991
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $21,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,991
Insurance broker organization code?3
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-01
Policy instance 2
Insurance contract or identification number01-015173-01
Number of Individuals Covered99
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $3,697
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,647
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,697
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-00
Policy instance 1
Insurance contract or identification number01-015173-00
Number of Individuals Covered99
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $2,534
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $18,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,534
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-00
Policy instance 1
Insurance contract or identification number01-015173-00
Number of Individuals Covered101
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $2,124
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $15,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,124
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-01
Policy instance 2
Insurance contract or identification number01-015173-01
Number of Individuals Covered101
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $2,682
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,682
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-00
Policy instance 1
Insurance contract or identification number01-015173-00
Number of Individuals Covered114
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $1,896
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $13,786
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,896
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-01
Policy instance 2
Insurance contract or identification number01-015173-01
Number of Individuals Covered116
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $2,340
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,340
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-01
Policy instance 2
Insurance contract or identification number01-015173-01
Number of Individuals Covered110
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $3,183
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,183
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-00
Policy instance 1
Insurance contract or identification number01-015173-00
Number of Individuals Covered108
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $2,832
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $11,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,832
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-01
Policy instance 1
Insurance contract or identification number01-015173-01
Number of Individuals Covered100
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $2,450
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,450
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-01
Policy instance 1
Insurance contract or identification number01-015173-01
Number of Individuals Covered96
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $2,661
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,661
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173-01
Policy instance 1
Insurance contract or identification number01-015173-01
Number of Individuals Covered103
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $2,448
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-015173
Policy instance 1
Insurance contract or identification number01-015173
Number of Individuals Covered105
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $2,620
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,620
Insurance broker organization code?3
Insurance broker nameTHE BERT COMPANY

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