401k Plan data: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN plan

AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 401k Plan overview

Plan Name	AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN
Plan identification number	501

AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

AFS TECHNOLOGIES HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name: AFS TECHNOLOGIES HOLDINGS, INC.

Employer identification number (EIN): 463012176

NAIC Classification: 443142
NAIC Description: Electronics Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-01-01
501 2021-01-01 NAOMI PEROS
501 2020-01-01
501 2019-01-01
501 2016-01-01 PATRICIA BRAMER
501 2015-01-01 PATRICIA BRAMER PATRICIA BRAMER 2016-07-13
501 2014-01-01 MARK SCHONAN
501 2013-01-01 MARK SCHONAU

Plan Statistics for AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN

401k plan membership statisitcs for AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN

Measure Date Value
2021: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 242
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 255
Number of retired or separated participants receiving benefits 2021-01-01 3
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 258
Total participants 2021-01-01 258
2020: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 212
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 239
Number of retired or separated participants receiving benefits 2020-01-01 3
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 242
Total participants 2020-01-01 242
2019: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 221
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 208
Number of retired or separated participants receiving benefits 2019-01-01 4
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 212
Total participants 2019-01-01 212
2016: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 228
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 228
Number of retired or separated participants receiving benefits 2016-01-01 4
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 232
2015: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 268
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 258
Number of retired or separated participants receiving benefits 2015-01-01 6
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 264
2014: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 280
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 288
Number of retired or separated participants receiving benefits 2014-01-01 6
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 294
2013: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 315
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 276
Number of retired or separated participants receiving benefits 2013-01-01 4
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 280

Measure	Date	Value
2021: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	242
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	255
Number of retired or separated participants receiving benefits	2021-01-01	3
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	258
Total participants	2021-01-01	258
2020: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	212
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	239
Number of retired or separated participants receiving benefits	2020-01-01	3
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	242
Total participants	2020-01-01	242
2019: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	221
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	208
Number of retired or separated participants receiving benefits	2019-01-01	4
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	212
Total participants	2019-01-01	212
2016: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	228
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	228
Number of retired or separated participants receiving benefits	2016-01-01	4
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	232
2015: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	268
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	258
Number of retired or separated participants receiving benefits	2015-01-01	6
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	264
2014: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	280
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	288
Number of retired or separated participants receiving benefits	2014-01-01	6
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	294
2013: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	315
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	276
Number of retired or separated participants receiving benefits	2013-01-01	4
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	280

Form 5500 Responses for AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN

2021: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH 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: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 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 – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: AFS TECHNOLOGIES HOLDINGS, INC. HEALTH PLAN 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 – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract number	GMNY6X00-7Z33
Policy instance	4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	10041211001
Policy instance	3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00617428
Policy instance	2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AY8Q
Policy instance	1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00617428
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AY8Q
Policy instance	2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	10041211001
Policy instance	3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract number
Policy instance	4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AY8Q
Policy instance	7
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AY8Q
Policy instance	6
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AY8Q
Policy instance	5
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AY8Q
Policy instance	4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AY8Q
Policy instance	3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00617428
Policy instance	2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	10041211001
Policy instance	1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	KM05913339
Policy instance	1
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	903653
Policy instance	2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5913339
Policy instance	2
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3331626
Policy instance	1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	97200
Policy instance	2
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3331626
Policy instance	1

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Company Name:	AFS TECHNOLOGIES HOLDINGS, INC.
Employer identification number (EIN):	463012176
NAIC Classification:	443142
NAIC Description:	Electronics Stores

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2021-01-01
501	2021-01-01	NAOMI PEROS
501	2020-01-01
501	2019-01-01
501	2016-01-01	PATRICIA BRAMER
501	2015-01-01	PATRICIA BRAMER	PATRICIA BRAMER	2016-07-13
501	2014-01-01	MARK SCHONAN
501	2013-01-01	MARK SCHONAU