401k Plan data: MERCHANTS GROCERS HEALTH PLAN plan

MERCHANTS GROCERS HEALTH PLAN 401k Plan overview

Plan Name	MERCHANTS GROCERS HEALTH PLAN
Plan identification number	501

MERCHANTS GROCERS HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Vision

401k Sponsoring company profile

MERCHANTS GROCERY COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: MERCHANTS GROCERY COMPANY, INC.

Employer identification number (EIN): 540301080

NAIC Classification: 445110
NAIC Description: Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MERCHANTS GROCERS HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-07-01
501 2020-07-01
501 2019-07-01
501 2017-07-01 NEAL DEANE NEAL DEANE 2019-01-30
501 2016-07-01 NEAL DEANE NEAL DEANE 2018-01-24
501 2015-07-01 NEAL DEANE NEAL DEANE 2017-01-18
501 2014-07-01 NEAL DEANE NEAL DEANE 2016-01-28
501 2013-07-01 NEAL DEANE NEAL DEANE 2015-01-26
501 2012-07-01 ELVIN SMYTHERS ELVIN SMYTHERS 2014-07-07
501 2011-07-01 ELVIN SMYTHERS ELVIN SMYTHERS 2013-01-07
501 2009-07-01 CHRISTIE SHEATS
501 2008-07-01 CHRISTIE SHEATS

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2020-07-01
501	2020-07-01
501	2019-07-01
501	2017-07-01	NEAL DEANE	NEAL DEANE	2019-01-30
501	2016-07-01	NEAL DEANE	NEAL DEANE	2018-01-24
501	2015-07-01	NEAL DEANE	NEAL DEANE	2017-01-18
501	2014-07-01	NEAL DEANE	NEAL DEANE	2016-01-28
501	2013-07-01	NEAL DEANE	NEAL DEANE	2015-01-26
501	2012-07-01	ELVIN SMYTHERS	ELVIN SMYTHERS	2014-07-07
501	2011-07-01	ELVIN SMYTHERS	ELVIN SMYTHERS	2013-01-07
501	2009-07-01	CHRISTIE SHEATS
501	2008-07-01	CHRISTIE SHEATS

Plan Statistics for MERCHANTS GROCERS HEALTH PLAN

401k plan membership statisitcs for MERCHANTS GROCERS HEALTH PLAN

Measure Date Value
2020: MERCHANTS GROCERS HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 157
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 110
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 0
Total of all active and inactive participants 2020-07-01 110
2019: MERCHANTS GROCERS HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 157
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 153
Number of retired or separated participants receiving benefits 2019-07-01 1
Total of all active and inactive participants 2019-07-01 154
Total participants 2019-07-01 154
2017: MERCHANTS GROCERS HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 167
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 157
Total of all active and inactive participants 2017-07-01 157
Total participants 2017-07-01 157
2016: MERCHANTS GROCERS HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 160
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 167
Total of all active and inactive participants 2016-07-01 167
Total participants 2016-07-01 167
2015: MERCHANTS GROCERS HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 158
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 159
Number of retired or separated participants receiving benefits 2015-07-01 1
Total of all active and inactive participants 2015-07-01 160
Total participants 2015-07-01 160
2014: MERCHANTS GROCERS HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 176
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 156
Number of retired or separated participants receiving benefits 2014-07-01 2
Total of all active and inactive participants 2014-07-01 158
Total participants 2014-07-01 158
2013: MERCHANTS GROCERS HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 168
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 172
Number of retired or separated participants receiving benefits 2013-07-01 4
Total of all active and inactive participants 2013-07-01 176
Total participants 2013-07-01 176
2012: MERCHANTS GROCERS HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 179
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 168
Total of all active and inactive participants 2012-07-01 168
Total participants 2012-07-01 168
2011: MERCHANTS GROCERS HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 175
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 179
Total of all active and inactive participants 2011-07-01 179
Total participants 2011-07-01 179
2009: MERCHANTS GROCERS HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 181
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 175
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 0
Total of all active and inactive participants 2009-07-01 175
2008: MERCHANTS GROCERS HEALTH PLAN 2008 401k membership
Total participants, beginning-of-year 2008-07-01 181
Total number of active participants reported on line 7a of the Form 5500 2008-07-01 181
Number of retired or separated participants receiving benefits 2008-07-01 0
Number of other retired or separated participants entitled to future benefits 2008-07-01 0
Total of all active and inactive participants 2008-07-01 181

Measure	Date	Value
2020: MERCHANTS GROCERS HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	157
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	110
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	0
Total of all active and inactive participants	2020-07-01	110
2019: MERCHANTS GROCERS HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	157
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	153
Number of retired or separated participants receiving benefits	2019-07-01	1
Total of all active and inactive participants	2019-07-01	154
Total participants	2019-07-01	154
2017: MERCHANTS GROCERS HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	167
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	157
Total of all active and inactive participants	2017-07-01	157
Total participants	2017-07-01	157
2016: MERCHANTS GROCERS HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	160
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	167
Total of all active and inactive participants	2016-07-01	167
Total participants	2016-07-01	167
2015: MERCHANTS GROCERS HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	158
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	159
Number of retired or separated participants receiving benefits	2015-07-01	1
Total of all active and inactive participants	2015-07-01	160
Total participants	2015-07-01	160
2014: MERCHANTS GROCERS HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	176
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	156
Number of retired or separated participants receiving benefits	2014-07-01	2
Total of all active and inactive participants	2014-07-01	158
Total participants	2014-07-01	158
2013: MERCHANTS GROCERS HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	168
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	172
Number of retired or separated participants receiving benefits	2013-07-01	4
Total of all active and inactive participants	2013-07-01	176
Total participants	2013-07-01	176
2012: MERCHANTS GROCERS HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	179
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	168
Total of all active and inactive participants	2012-07-01	168
Total participants	2012-07-01	168
2011: MERCHANTS GROCERS HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	175
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	179
Total of all active and inactive participants	2011-07-01	179
Total participants	2011-07-01	179
2009: MERCHANTS GROCERS HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	181
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	175
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	0
Total of all active and inactive participants	2009-07-01	175
2008: MERCHANTS GROCERS HEALTH PLAN 2008 401k membership
Total participants, beginning-of-year	2008-07-01	181
Total number of active participants reported on line 7a of the Form 5500	2008-07-01	181
Number of retired or separated participants receiving benefits	2008-07-01	0
Number of other retired or separated participants entitled to future benefits	2008-07-01	0
Total of all active and inactive participants	2008-07-01	181

Form 5500 Responses for MERCHANTS GROCERS HEALTH PLAN

2020: MERCHANTS GROCERS HEALTH PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: MERCHANTS GROCERS HEALTH PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2017: MERCHANTS GROCERS HEALTH PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2016: MERCHANTS GROCERS HEALTH PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: MERCHANTS GROCERS HEALTH PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: MERCHANTS GROCERS HEALTH PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: MERCHANTS GROCERS HEALTH PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: MERCHANTS GROCERS HEALTH PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2011: MERCHANTS GROCERS HEALTH PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2009: MERCHANTS GROCERS HEALTH PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2008: MERCHANTS GROCERS HEALTH PLAN 2008 form 5500 responses
2008-07-01	Type of plan entity	Single employer plan
2008-07-01	First time form 5500 has been submitted	Yes
2008-07-01	Submission has been amended	No
2008-07-01	This submission is the final filing	No
2008-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-07-01	Plan is a collectively bargained plan	No
2008-07-01	Plan funding arrangement – Insurance	Yes
2008-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00630081
Policy instance	1
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	06372-2
Policy instance	2
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	06372-1
Policy instance	1
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	06372-2
Policy instance	2
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	06372-1
Policy instance	1
SH-COVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 96555 )
Policy contract number	9320510000
Policy instance	2
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number	9320510000
Policy instance	1
SH-COVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 96555 )
Policy contract number	9320510000
Policy instance	2
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number	9320510000
Policy instance	1
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	06372
Policy instance	2
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	06372
Policy instance	1
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	06372
Policy instance	2
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	06372
Policy instance	1
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	06372
Policy instance	2
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	06372
Policy instance	1

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Company Name:	MERCHANTS GROCERY COMPANY, INC.
Employer identification number (EIN):	540301080
NAIC Classification:	445110
NAIC Description:	Supermarkets and Other Grocery (except Convenience) Stores