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| Plan Name | FRESH THYME FARMERS MARKET GROUP CRITCAL ILLNESS AND ACCIDENT PLAN |
| Plan identification number | 506 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | LAKES VENTURE LLC, D/B/A FRESH THYME MARKET |
| Employer identification number (EIN): | 461124457 |
| NAIC Classification: | 445110 |
| NAIC Description: | Supermarkets and Other Grocery (except Convenience) Stores |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 506 | 2016-01-01 | DANIELLE BOYD | |||
| 506 | 2016-01-01 | JEFF POWERS | 2020-09-21 | ||
| 506 | 2015-01-01 | DANIELLE BOYD | DANIELLE BOYD | 2016-07-26 |
| Measure | Date | Value |
|---|---|---|
| 2016: FRESH THYME FARMERS MARKET GROUP CRITCAL ILLNESS AND ACCIDENT PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 723 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 1,150 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 1,150 |
| 2015: FRESH THYME FARMERS MARKET GROUP CRITCAL ILLNESS AND ACCIDENT PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 248 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 0 |
| 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 | 0 |
| 2016: FRESH THYME FARMERS MARKET GROUP CRITCAL ILLNESS AND ACCIDENT PLAN 2016 form 5500 responses | ||
|---|---|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FRESH THYME FARMERS MARKET GROUP CRITCAL ILLNESS AND ACCIDENT PLAN 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | Yes |
| 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 – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||||||||||||
| Policy contract number | R0567966 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
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