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HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 401k Plan overview

Plan NameHAAS OUTDOORS SECTION 125 CAFETERIA PLAN
Plan identification number 501

HAAS OUTDOORS SECTION 125 CAFETERIA PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

HAAS OUTDOORS, INC. has sponsored the creation of one or more 401k plans.

Company Name:HAAS OUTDOORS, INC.
Employer identification number (EIN):640724670
NAIC Classification:451110
NAIC Description:Sporting Goods Stores

Additional information about HAAS OUTDOORS, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1997-06-30
Company Identification Number: 0011607406
Legal Registered Office Address: PO BOX 757

WEST POINT
United States of America (USA)
39773

More information about HAAS OUTDOORS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HAAS OUTDOORS SECTION 125 CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-10-01
5012020-10-01
5012019-10-01
5012018-10-01
5012017-10-01
5012016-10-01LADONNA HELVESTON TOXEY HAAS2018-06-04
5012015-10-01LADONNA HELVESTON TOXEY HAAS2017-04-28
5012014-10-01LADONNA HELVESTON TOXEY HAAS2016-05-31
5012013-10-01TOXEY HAAS TOXEY HAAS2015-07-15
5012012-10-01TOXEY HAAS TOXEY HAAS2014-07-31

Plan Statistics for HAAS OUTDOORS SECTION 125 CAFETERIA PLAN

401k plan membership statisitcs for HAAS OUTDOORS SECTION 125 CAFETERIA PLAN

Measure Date Value
2021: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01129
Total number of active participants reported on line 7a of the Form 55002021-10-01280
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01280
2020: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01130
Total number of active participants reported on line 7a of the Form 55002020-10-01129
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01129
2019: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01132
Total number of active participants reported on line 7a of the Form 55002019-10-01130
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01130
2018: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01130
Total number of active participants reported on line 7a of the Form 55002018-10-01132
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01132
2017: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01134
Total number of active participants reported on line 7a of the Form 55002017-10-01130
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01130
2016: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01127
Total number of active participants reported on line 7a of the Form 55002016-10-01134
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01134
2015: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01129
Total number of active participants reported on line 7a of the Form 55002015-10-01127
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01127
2014: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01121
Total number of active participants reported on line 7a of the Form 55002014-10-01129
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01129
2013: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01102
Total number of active participants reported on line 7a of the Form 55002013-10-01109
Total of all active and inactive participants2013-10-01109
2012: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01100
Total number of active participants reported on line 7a of the Form 55002012-10-01102
Total of all active and inactive participants2012-10-01102
Total participants2012-10-01102

Form 5500 Responses for HAAS OUTDOORS SECTION 125 CAFETERIA PLAN

2021: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – InsuranceYes
2020: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes
2013: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: HAAS OUTDOORS SECTION 125 CAFETERIA PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01First time form 5500 has been submittedYes
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05392180
Policy instance 2
Insurance contract or identification numberTS05392180
Number of Individuals Covered280
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $22,455
Total amount of fees paid to insurance companyUSD $1,458
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $142,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,350
Insurance broker organization code?3
Amount paid for insurance broker fees1458
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1099294
Policy instance 1
Insurance contract or identification number1099294
Number of Individuals Covered129
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $366
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $366
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00553869
Policy instance 2
Insurance contract or identification number00553869
Number of Individuals Covered121
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $14,199
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $141,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,199
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1099294
Policy instance 1
Insurance contract or identification number1099294
Number of Individuals Covered129
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $3,534
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,534
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00553869
Policy instance 2
Insurance contract or identification number00553869
Number of Individuals Covered122
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $13,100
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $131,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,100
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1099294
Policy instance 1
Insurance contract or identification number1099294
Number of Individuals Covered130
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $3,279
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,279
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1099294
Policy instance 1
Insurance contract or identification number1099294
Number of Individuals Covered132
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $3,368
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,368
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00553869
Policy instance 2
Insurance contract or identification number00553869
Number of Individuals Covered120
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $10,452
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $100,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,069
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number618233
Policy instance 2
Insurance contract or identification number618233
Number of Individuals Covered82
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $11,514
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number226144
Policy instance 1
Insurance contract or identification number226144
Number of Individuals Covered130
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $2,521
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number226144
Policy instance 1
Insurance contract or identification number226144
Number of Individuals Covered127
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $2,822
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,822
Insurance broker organization code?3
Insurance broker nameGCM INSURANCE AGENCY LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number226144
Policy instance 1
Insurance contract or identification number226144
Number of Individuals Covered129
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $2,254
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,087
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,254
Insurance broker organization code?3
Insurance broker nameGCM INSURANCE AGENCY LLC
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL15885
Policy instance 1
Insurance contract or identification numberHCL15885
Number of Individuals Covered109
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $164,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL15885
Policy instance 1
Insurance contract or identification numberHCL15885
Number of Individuals Covered100
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $195,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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