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| Plan Name | FAMILY HOME FURNISHINGS, HEALTH AND WELLNESS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | FAMILY HOME FURNISHINGS INC. TRIVET'S FURNITURE DBA FAMILY HOME FURNIS |
| Employer identification number (EIN): | 541617984 |
| NAIC Classification: | 442110 |
| NAIC Description: | Furniture Stores |
Additional information about FAMILY HOME FURNISHINGS INC. TRIVET'S FURNITURE DBA FAMILY HOME FURNIS
| Jurisdiction of Incorporation: | Virginia Secretary of State |
| Incorporation Date: | 1992-03-23 |
| Company Identification Number: | 0390040 |
| Legal Registered Office Address: |
3986 PLANK ROAD FREDERICKSBURG United States of America (USA) 22407 |
More information about FAMILY HOME FURNISHINGS INC. TRIVET'S FURNITURE DBA FAMILY HOME FURNIS
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-06-01 | ||||
| 501 | 2021-06-01 | ||||
| 501 | 2020-06-01 |
| Measure | Date | Value |
|---|---|---|
| 2022: FAMILY HOME FURNISHINGS, HEALTH AND WELLNESS PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-06-01 | 223 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 202 |
| Number of retired or separated participants receiving benefits | 2022-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-06-01 | 0 |
| Total of all active and inactive participants | 2022-06-01 | 202 |
| 2021: FAMILY HOME FURNISHINGS, HEALTH AND WELLNESS PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-06-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 107 |
| Number of retired or separated participants receiving benefits | 2021-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-06-01 | 0 |
| Total of all active and inactive participants | 2021-06-01 | 107 |
| 2020: FAMILY HOME FURNISHINGS, HEALTH AND WELLNESS PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-06-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 111 |
| Number of retired or separated participants receiving benefits | 2020-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-06-01 | 0 |
| Total of all active and inactive participants | 2020-06-01 | 111 |
| 2022: FAMILY HOME FURNISHINGS, HEALTH AND WELLNESS PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-06-01 | Type of plan entity | Single employer plan |
| 2022-06-01 | Submission has been amended | No |
| 2022-06-01 | This submission is the final filing | No |
| 2022-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-06-01 | Plan is a collectively bargained plan | No |
| 2022-06-01 | Plan funding arrangement – Insurance | Yes |
| 2022-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: FAMILY HOME FURNISHINGS, HEALTH AND WELLNESS PLAN 2021 form 5500 responses | ||
| 2021-06-01 | Type of plan entity | Single employer plan |
| 2021-06-01 | Submission has been amended | No |
| 2021-06-01 | This submission is the final filing | No |
| 2021-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-06-01 | Plan is a collectively bargained plan | No |
| 2021-06-01 | Plan funding arrangement – Insurance | Yes |
| 2021-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: FAMILY HOME FURNISHINGS, HEALTH AND WELLNESS PLAN 2020 form 5500 responses | ||
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | First time form 5500 has been submitted | Yes |
| 2020-06-01 | Submission has been amended | No |
| 2020-06-01 | This submission is the final filing | No |
| 2020-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-06-01 | Plan is a collectively bargained plan | No |
| 2020-06-01 | Plan funding arrangement – Insurance | Yes |
| 2020-06-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 927757 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 370111 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 081723 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 081723 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| GUARDIAN (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00446931 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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