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| Plan Name | ELLWOOD THOMPSONS LOCAL MARKET LIFE & DISABILITY PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ELLWOOD THOMPSONS LOCAL MARKET |
| Employer identification number (EIN): | 541720274 |
| NAIC Classification: | 445110 |
| NAIC Description: | Supermarkets and Other Grocery (except Convenience) Stores |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2017-08-01 | DIANA RODRIGUEZ | DIANA RODRIGUEZ | 2019-02-11 | |
| 503 | 2016-08-01 | LAURIE BOST | LAURIE BOST | 2018-02-22 |
| 2017: ELLWOOD THOMPSONS LOCAL MARKET LIFE & DISABILITY PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-08-01 | Type of plan entity | Single employer plan |
| 2017-08-01 | Submission has been amended | No |
| 2017-08-01 | This submission is the final filing | No |
| 2017-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-08-01 | Plan is a collectively bargained plan | No |
| 2017-08-01 | Plan funding arrangement – Insurance | Yes |
| 2017-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: ELLWOOD THOMPSONS LOCAL MARKET LIFE & DISABILITY PLAN 2016 form 5500 responses | ||
| 2016-08-01 | Type of plan entity | Single employer plan |
| 2016-08-01 | Submission has been amended | No |
| 2016-08-01 | This submission is the final filing | No |
| 2016-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-08-01 | Plan is a collectively bargained plan | No |
| 2016-08-01 | Plan funding arrangement – Insurance | Yes |
| 2016-08-01 | Plan benefit arrangement – Insurance | Yes |
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) | |
| Policy contract number | AL00004240 |
| Policy instance | 1 |
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