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| Plan Name | TREE HOUSE BREWING HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | TREE HOUSE BREWING COMPANY INC |
| Employer identification number (EIN): | 472743814 |
| NAIC Classification: | 312120 |
| NAIC Description: | Breweries |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-08-01 | JENNIFER WEBSTER | 2023-12-18 |
| Measure | Date | Value |
|---|---|---|
| 2022: TREE HOUSE BREWING HEALTH AND WELFARE PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-08-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-08-01 | 112 |
| Number of retired or separated participants receiving benefits | 2022-08-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-08-01 | 0 |
| Total of all active and inactive participants | 2022-08-01 | 112 |
| Number of employers contributing to the scheme | 2022-08-01 | 0 |
| 2022: TREE HOUSE BREWING HEALTH AND WELFARE PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-08-01 | Type of plan entity | Single employer plan |
| 2022-08-01 | First time form 5500 has been submitted | Yes |
| 2022-08-01 | Plan funding arrangement – Insurance | Yes |
| 2022-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-08-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) | |
| Policy contract number | 14103 |
| Policy instance | 1 |
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) | |
| Policy contract number | 118614 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 23613 |
| Policy instance | 3 |
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