401k Plan data: ASTIN HARVESTING, INC. BENEFIT PLAN plan

ASTIN HARVESTING, INC. BENEFIT PLAN 401k Plan overview

Plan Name	ASTIN HARVESTING, INC. BENEFIT PLAN
Plan identification number	502

ASTIN HARVESTING, INC. BENEFIT 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) Death benefits (include travel accident but not life insurance) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

ASTIN HARVESTING, INC. has sponsored the creation of one or more 401k plans.

Company Name: ASTIN HARVESTING, INC.

Employer identification number (EIN): 472580852

NAIC Classification: 111300
NAIC Description: Fruit and Tree Nut Farming

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASTIN HARVESTING, INC. BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2021-12-01 MARISSA ROBERTS MCQUAIG 2023-04-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2021-12-01	MARISSA ROBERTS MCQUAIG	2023-04-12

Plan Statistics for ASTIN HARVESTING, INC. BENEFIT PLAN

401k plan membership statisitcs for ASTIN HARVESTING, INC. BENEFIT PLAN

Measure Date Value
2021: ASTIN HARVESTING, INC. BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-12-01 100
Total number of active participants reported on line 7a of the Form 5500 2021-12-01 55
Number of retired or separated participants receiving benefits 2021-12-01 0
Number of other retired or separated participants entitled to future benefits 2021-12-01 0
Total of all active and inactive participants 2021-12-01 55
Number of employers contributing to the scheme 2021-12-01 0

Measure	Date	Value
2021: ASTIN HARVESTING, INC. BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-12-01	100
Total number of active participants reported on line 7a of the Form 5500	2021-12-01	55
Number of retired or separated participants receiving benefits	2021-12-01	0
Number of other retired or separated participants entitled to future benefits	2021-12-01	0
Total of all active and inactive participants	2021-12-01	55
Number of employers contributing to the scheme	2021-12-01	0

Form 5500 Responses for ASTIN HARVESTING, INC. BENEFIT PLAN

2021: ASTIN HARVESTING, INC. BENEFIT PLAN 2021 form 5500 responses
2021-12-01	Type of plan entity	Single employer plan
2021-12-01	First time form 5500 has been submitted	Yes
2021-12-01	Plan funding arrangement – Insurance	Yes
2021-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )

Policy contract number

B9993

Policy instance

Insurance contract or identification number	B9993
Number of Individuals Covered	11
Insurance policy start date	2021-12-01
Insurance policy end date	2022-11-30
Total amount of commissions paid to insurance broker	USD $8,384
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,384
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05955483

Policy instance

Insurance contract or identification number	TM05955483
Number of Individuals Covered	129
Insurance policy start date	2021-12-01
Insurance policy end date	2022-11-30
Total amount of commissions paid to insurance broker	USD $4,420
Total amount of fees paid to insurance company	USD $592
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $37,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,420
Amount paid for insurance broker fees	37
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E4923678

Policy instance

Insurance contract or identification number	E4923678
Number of Individuals Covered	41
Insurance policy start date	2021-12-01
Insurance policy end date	2022-11-30
Total amount of commissions paid to insurance broker	USD $6,473
Total amount of fees paid to insurance company	USD $877
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to Carrier	USD $43,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,753
Amount paid for insurance broker fees	392
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )

Policy contract number

B9993

Policy instance

Insurance contract or identification number	B9993
Number of Individuals Covered	18
Insurance policy start date	2021-12-01
Insurance policy end date	2022-11-30
Total amount of commissions paid to insurance broker	USD $8,610
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,610
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	ASTIN HARVESTING, INC.
Employer identification number (EIN):	472580852
NAIC Classification:	111300
NAIC Description:	Fruit and Tree Nut Farming