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| Plan Name | MALLORY SAFETY AND SUPPLY HRA |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MALLORY SAFETY AND SUPPLY LLC |
| Employer identification number (EIN): | 273905150 |
| NAIC Classification: | 423990 |
| NAIC Description: | Other Miscellaneous Durable Goods Merchant Wholesalers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2022-01-01 | HALEY ROTT | 2022-10-17 | ||
| 502 | 2022-01-01 | HALEY ROTT | 2023-12-19 | ||
| 502 | 2021-01-01 | ABIGAIL DILLAVOU | 2022-03-09 |
| Measure | Date | Value |
|---|---|---|
| 2022: MALLORY SAFETY AND SUPPLY HRA 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 195 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 195 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 195 |
| Number of employers contributing to the scheme | 2022-01-01 | 0 |
| 2021: MALLORY SAFETY AND SUPPLY HRA 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 195 |
| 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 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 195 |
| Number of employers contributing to the scheme | 2021-01-01 | 0 |
| 2022: MALLORY SAFETY AND SUPPLY HRA 2022 form 5500 responses | ||
|---|---|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | Yes |
| 2022-01-01 | This submission is the final filing | Yes |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: MALLORY SAFETY AND SUPPLY HRA 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
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