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Plan Name | GPM SOUTHEAST, LLC HEALTH PLAN |
Plan identification number | 502 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | GPM SOUTHEAST, LLC |
Employer identification number (EIN): | 462489565 |
NAIC Classification: | 445120 |
NAIC Description: | Convenience Stores |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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502 | 2018-01-01 | TAMMY L. MITCHELL | 2019-10-01 | ||
502 | 2018-01-01 | TAMMY L. MITCHELL | 2020-09-21 |
Measure | Date | Value |
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2018: GPM SOUTHEAST, LLC HEALTH PLAN 2018 401k membership | ||
Total participants, beginning-of-year | 2018-01-01 | 780 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 683 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 5 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 688 |
Number of employers contributing to the scheme | 2018-01-01 | 0 |
2018: GPM SOUTHEAST, LLC HEALTH PLAN 2018 form 5500 responses | ||
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | First time form 5500 has been submitted | Yes |
2018-01-01 | Submission has been amended | Yes |
2018-01-01 | This submission is the final filing | Yes |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 1701709 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 10091511001 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 11258274 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 656841 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||
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