401k Plan data: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE plan

NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 401k Plan overview

Plan Name	NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE
Plan identification number	502

NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE Benefits

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

401k Sponsoring company profile

SMS CORP OFFICE has sponsored the creation of one or more 401k plans.

Company Name: SMS CORP OFFICE

Employer identification number (EIN): 570439385

NAIC Classification: 722513
NAIC Description: Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2013-05-01
502 2012-05-01 LAWRENCE STOKES II
502 2011-05-01 LAWRENCE STOKES II

Plan Statistics for NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE

401k plan membership statisitcs for NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE

Measure Date Value
2013: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2013 401k membership
Total participants, beginning-of-year 2013-05-01 15
Total number of active participants reported on line 7a of the Form 5500 2013-05-01 14
Number of retired or separated participants receiving benefits 2013-05-01 0
Number of other retired or separated participants entitled to future benefits 2013-05-01 0
Total of all active and inactive participants 2013-05-01 14
2012: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2012 401k membership
Total participants, beginning-of-year 2012-05-01 15
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 15
Number of retired or separated participants receiving benefits 2012-05-01 0
Number of other retired or separated participants entitled to future benefits 2012-05-01 0
Total of all active and inactive participants 2012-05-01 15
2011: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2011 401k membership
Total participants, beginning-of-year 2011-05-01 20
Total number of active participants reported on line 7a of the Form 5500 2011-05-01 15
Number of retired or separated participants receiving benefits 2011-05-01 0
Number of other retired or separated participants entitled to future benefits 2011-05-01 0
Total of all active and inactive participants 2011-05-01 15

Measure	Date	Value
2013: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2013 401k membership
Total participants, beginning-of-year	2013-05-01	15
Total number of active participants reported on line 7a of the Form 5500	2013-05-01	14
Number of retired or separated participants receiving benefits	2013-05-01	0
Number of other retired or separated participants entitled to future benefits	2013-05-01	0
Total of all active and inactive participants	2013-05-01	14
2012: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2012 401k membership
Total participants, beginning-of-year	2012-05-01	15
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	15
Number of retired or separated participants receiving benefits	2012-05-01	0
Number of other retired or separated participants entitled to future benefits	2012-05-01	0
Total of all active and inactive participants	2012-05-01	15
2011: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2011 401k membership
Total participants, beginning-of-year	2011-05-01	20
Total number of active participants reported on line 7a of the Form 5500	2011-05-01	15
Number of retired or separated participants receiving benefits	2011-05-01	0
Number of other retired or separated participants entitled to future benefits	2011-05-01	0
Total of all active and inactive participants	2011-05-01	15

Financial Data on NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE

Measure	Date	Value
2013 : NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2013 401k financial data
Total plan liabilities at end of year	2013-04-30	$1,923
Total plan liabilities at beginning of year	2013-04-30	$10,041
Total income from all sources	2013-04-30	$149,779
Expenses. Total of all expenses incurred	2013-04-30	$149,779
Benefits paid (including direct rollovers)	2013-04-30	$71,123
Total plan assets at end of year	2013-04-30	$1,923
Total plan assets at beginning of year	2013-04-30	$10,041
Expenses. Other expenses not covered elsewhere	2013-04-30	$78,656
Net income (gross income less expenses)	2013-04-30	$0
Net plan assets at end of year (total assets less liabilities)	2013-04-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-04-30	$0
Total contributions received or receivable from employer(s)	2013-04-30	$149,779
2012 : NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2012 401k financial data
Total plan liabilities at end of year	2012-04-30	$10,041
Total plan liabilities at beginning of year	2012-04-30	$7,518
Total income from all sources	2012-04-30	$133,721
Expenses. Total of all expenses incurred	2012-04-30	$133,721
Benefits paid (including direct rollovers)	2012-04-30	$62,496
Total plan assets at end of year	2012-04-30	$10,041
Total plan assets at beginning of year	2012-04-30	$7,518
Expenses. Other expenses not covered elsewhere	2012-04-30	$71,225
Net income (gross income less expenses)	2012-04-30	$0
Net plan assets at end of year (total assets less liabilities)	2012-04-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-04-30	$0
Total contributions received or receivable from employer(s)	2012-04-30	$133,721
2011 : NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2011 401k financial data
Total plan liabilities at end of year	2011-04-30	$7,518
Total plan liabilities at beginning of year	2011-04-30	$0
Total income from all sources	2011-04-30	$144,776
Expenses. Total of all expenses incurred	2011-04-30	$144,776
Benefits paid (including direct rollovers)	2011-04-30	$74,379
Total plan assets at end of year	2011-04-30	$7,518
Total plan assets at beginning of year	2011-04-30	$0
Expenses. Other expenses not covered elsewhere	2011-04-30	$70,397
Net income (gross income less expenses)	2011-04-30	$0
Net plan assets at end of year (total assets less liabilities)	2011-04-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2011-04-30	$0
Total contributions received or receivable from employer(s)	2011-04-30	$144,776

Form 5500 Responses for NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE

2013: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2013 form 5500 responses
2013-05-01	Type of plan entity	Single employer plan
2013-05-01	Submission has been amended	No
2013-05-01	This submission is the final filing	No
2013-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-05-01	Plan is a collectively bargained plan	No
2013-05-01	Plan funding arrangement – Insurance	Yes
2013-05-01	Plan funding arrangement – Trust	Yes
2013-05-01	Plan benefit arrangement – Insurance	Yes
2013-05-01	Plan benefit arrangement - Trust	Yes
2012: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2012 form 5500 responses
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	Submission has been amended	No
2012-05-01	This submission is the final filing	No
2012-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-05-01	Plan is a collectively bargained plan	No
2012-05-01	Plan funding arrangement – Insurance	Yes
2012-05-01	Plan funding arrangement – Trust	Yes
2012-05-01	Plan benefit arrangement – Insurance	Yes
2012-05-01	Plan benefit arrangement - Trust	Yes
2011: NFA HEALTH PLUS EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE 2011 form 5500 responses
2011-05-01	Type of plan entity	Single employer plan
2011-05-01	Submission has been amended	No
2011-05-01	This submission is the final filing	No
2011-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-05-01	Plan is a collectively bargained plan	No
2011-05-01	Plan funding arrangement – Insurance	Yes
2011-05-01	Plan funding arrangement – Trust	Yes
2011-05-01	Plan benefit arrangement – Insurance	Yes
2011-05-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )

Policy contract number

12371 NFA 0088

Policy instance

Insurance contract or identification number	12371 NFA 0088
Number of Individuals Covered	25
Insurance policy start date	2013-05-01
Insurance policy end date	2014-04-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

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Company Name:	SMS CORP OFFICE
Employer identification number (EIN):	570439385
NAIC Classification:	722513
NAIC Description:	Limited-Service Restaurants

Plan id#	Filing Submission Date	Name of Administrator
502	2013-05-01
502	2012-05-01	LAWRENCE STOKES II
502	2011-05-01	LAWRENCE STOKES II