401k Plan data: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT plan

LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 401k Plan overview

Plan Name	LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT
Plan identification number	503

LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Other welfare benefit cover

401k Sponsoring company profile

LEWIS OPERATING CORP. has sponsored the creation of one or more 401k plans.

Company Name: LEWIS OPERATING CORP.

Employer identification number (EIN): 330830657

NAIC Classification: 531390
NAIC Description: Other Activities Related to Real Estate

Additional information about LEWIS OPERATING CORP.

Jurisdiction of Incorporation: California Department of State

Incorporation Date: 1998-11-24

Company Identification Number: C2126379

Legal Registered Office Address: 1156 N Mountain Ave

Upland
United States of America (USA)
91786

More information about LEWIS OPERATING CORP.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2015-01-01 MICHAEL BAINS PHILLIP BURBACH 2016-10-07
503 2014-01-01 PHILLIP BURBACH
503 2014-01-01 PHILLIP BURBACH
503 2013-01-01 PHILLIP BURBACH
503 2012-01-01 PHILLIP BURBACH
503 2011-01-01 PHILLIP BURBACH
503 2010-01-01 PHILLIP BURBACH
503 2009-01-01 PHILLIP BURBACH

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2015-01-01	MICHAEL BAINS	PHILLIP BURBACH	2016-10-07
503	2014-01-01	PHILLIP BURBACH
503	2014-01-01	PHILLIP BURBACH
503	2013-01-01	PHILLIP BURBACH
503	2012-01-01	PHILLIP BURBACH
503	2011-01-01	PHILLIP BURBACH
503	2010-01-01	PHILLIP BURBACH
503	2009-01-01	PHILLIP BURBACH

Plan Statistics for LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT

401k plan membership statisitcs for LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT

Measure Date Value
2015: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2015 401k membership
Total participants, beginning-of-year 2015-01-01 349
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 315
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 315
2014: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2014 401k membership
Total participants, beginning-of-year 2014-01-01 293
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 349
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 349
2013: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year 2013-01-01 280
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 293
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 293
2012: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year 2012-01-01 292
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 278
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 278
2011: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year 2011-01-01 289
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 313
Total of all active and inactive participants 2011-01-01 313
2010: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2010 401k membership
Total participants, beginning-of-year 2010-01-01 287
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 272
Total of all active and inactive participants 2010-01-01 272
2009: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2009 401k membership
Total participants, beginning-of-year 2009-01-01 273
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 327
Total of all active and inactive participants 2009-01-01 327

Measure	Date	Value
2015: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2015 401k membership
Total participants, beginning-of-year	2015-01-01	349
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	315
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	315
2014: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2014 401k membership
Total participants, beginning-of-year	2014-01-01	293
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	349
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	349
2013: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year	2013-01-01	280
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	293
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	293
2012: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year	2012-01-01	292
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	278
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	278
2011: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year	2011-01-01	289
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	313
Total of all active and inactive participants	2011-01-01	313
2010: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2010 401k membership
Total participants, beginning-of-year	2010-01-01	287
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	272
Total of all active and inactive participants	2010-01-01	272
2009: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2009 401k membership
Total participants, beginning-of-year	2009-01-01	273
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	327
Total of all active and inactive participants	2009-01-01	327

Form 5500 Responses for LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT

2015: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: LEWIS OPERATING CORP. HEALTH REIMBURSEMENT ARRANGEMENT 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	LEWIS OPERATING CORP.
Employer identification number (EIN):	330830657
NAIC Classification:	531390
NAIC Description:	Other Activities Related to Real Estate

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:	1998-11-24
Company Identification Number:	C2126379
Legal Registered Office Address:	1156 N Mountain Ave Upland United States of America (USA) 91786