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| Plan Name | CANTON REGIONAL CHAMBER HEALTH FUND |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | KING MACHINE AND TOOL COMPANY |
| Employer identification number (EIN): | 341405195 |
| NAIC Classification: | 333200 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-10-01 |
| Measure | Date | Value |
|---|---|---|
| 2019: CANTON REGIONAL CHAMBER HEALTH FUND 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-10-01 | 40 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 40 |
| Number of retired or separated participants receiving benefits | 2019-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-10-01 | 0 |
| Total of all active and inactive participants | 2019-10-01 | 40 |
| Total participants | 2019-10-01 | 40 |
| Measure | Date | Value |
|---|---|---|
| 2019 : CANTON REGIONAL CHAMBER HEALTH FUND 2019 401k financial data | ||
| Transfers to/from the plan | 2019-12-31 | $-62 |
| Total plan liabilities at end of year | 2019-12-31 | $5,327 |
| Total plan liabilities at beginning of year | 2019-12-31 | $0 |
| Total income from all sources | 2019-12-31 | $56,842 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $52,311 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $14,484 |
| Total plan assets at end of year | 2019-12-31 | $9,796 |
| Total plan assets at beginning of year | 2019-12-31 | $0 |
| Total contributions received or receivable from participants | 2019-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2019-12-31 | $0 |
| Other income received | 2019-12-31 | $0 |
| Noncash contributions received | 2019-12-31 | $0 |
| Net income (gross income less expenses) | 2019-12-31 | $4,531 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $4,469 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $56,842 |
| Value of certain deemed distributions of participant loans | 2019-12-31 | $0 |
| Value of corrective distributions | 2019-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $37,827 |
| 2019: CANTON REGIONAL CHAMBER HEALTH FUND 2019 form 5500 responses | ||
|---|---|---|
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | First time form 5500 has been submitted | Yes |
| 2019-10-01 | Submission has been amended | No |
| 2019-10-01 | This submission is the final filing | No |
| 2019-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2019-10-01 | Plan is a collectively bargained plan | No |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | HF1905 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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