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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: | ARCHER SIGN CORPORATION |
| Employer identification number (EIN): | 341667784 |
| NAIC Classification: | 332900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-01-01 | BETH SHAHEEN | 2021-07-23 | JERRY ARCHER | 2021-07-23 |
| Measure | Date | Value |
|---|---|---|
| 2020: CANTON REGIONAL CHAMBER HEALTH FUND 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-01-01 | 12 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 8 |
| Total of all active and inactive participants | 2020-01-01 | 8 |
| Measure | Date | Value |
|---|---|---|
| 2020 : CANTON REGIONAL CHAMBER HEALTH FUND 2020 401k financial data | ||
| Transfers to/from the plan | 2020-12-31 | $13 |
| Total plan liabilities at end of year | 2020-12-31 | $9,604 |
| Total income from all sources | 2020-12-31 | $92,701 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $86,195 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $1,567 |
| Total plan assets at end of year | 2020-12-31 | $16,123 |
| Value of fidelity bond covering the plan | 2020-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $26,469 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $68 |
| Net income (gross income less expenses) | 2020-12-31 | $6,506 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $6,519 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $66,232 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $84,560 |
| 2020: CANTON REGIONAL CHAMBER HEALTH FUND 2020 form 5500 responses | ||
|---|---|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | First time form 5500 has been submitted | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 ) | |||||||||||||||||||
| Policy contract number | HF2170 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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