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PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan NamePAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN
Plan identification number 502

PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

PAY-LESS SUPERMARKET, INC has sponsored the creation of one or more 401k plans.

Company Name:PAY-LESS SUPERMARKET, INC
Employer identification number (EIN):720547406
NAIC Classification:445110
NAIC Description:Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022016-06-01ALLISON ROYSTER
5022015-06-01AMY GAUTREAUX
5022014-06-01AMY GAUTREAUX
5022013-06-01AMY GAUTREAUX
5022012-06-01AMY GAUTREAUX

Plan Statistics for PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN

Measure Date Value
2016: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01297
Total number of active participants reported on line 7a of the Form 55002016-06-01250
Total of all active and inactive participants2016-06-01250
Total participants2016-06-01250
2015: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01288
Total number of active participants reported on line 7a of the Form 55002015-06-01279
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-0110
Total of all active and inactive participants2015-06-01289
2014: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01268
Total number of active participants reported on line 7a of the Form 55002014-06-01262
Number of retired or separated participants receiving benefits2014-06-014
Number of other retired or separated participants entitled to future benefits2014-06-0126
Total of all active and inactive participants2014-06-01292
2013: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01269
Total number of active participants reported on line 7a of the Form 55002013-06-01192
Number of retired or separated participants receiving benefits2013-06-010
Number of other retired or separated participants entitled to future benefits2013-06-010
Total of all active and inactive participants2013-06-01192
2012: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-01213
Total number of active participants reported on line 7a of the Form 55002012-06-01269
Number of retired or separated participants receiving benefits2012-06-010
Number of other retired or separated participants entitled to future benefits2012-06-010
Total of all active and inactive participants2012-06-01269

Form 5500 Responses for PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN

2016: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01This submission is the final filingYes
2016-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Submission has been amendedNo
2015-06-01This submission is the final filingNo
2015-06-01This return/report is a short plan year return/report (less than 12 months)No
2015-06-01Plan is a collectively bargained planNo
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Submission has been amendedNo
2014-06-01This submission is the final filingNo
2014-06-01This return/report is a short plan year return/report (less than 12 months)No
2014-06-01Plan is a collectively bargained planNo
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: PAY-LESS SUPERMARKET, INC. EMPLOYEE BENEFITS PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01First time form 5500 has been submittedYes
2012-06-01Submission has been amendedNo
2012-06-01This submission is the final filingNo
2012-06-01This return/report is a short plan year return/report (less than 12 months)No
2012-06-01Plan is a collectively bargained planNo
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78E03ERC
Policy instance 3
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberD4143, 9671215
Policy instance 2
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberAG542
Policy instance 1
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberD4143 9671215
Policy instance 4
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78E03ERC
Policy instance 3
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number000000000000000
Policy instance 2
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberAG542
Policy instance 1
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78E03ERC
Policy instance 3
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number000000000000000
Policy instance 2
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberAG542
Policy instance 1
COVENTRY HEALTH CARE OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 95173 )
Policy contract number6901330000
Policy instance 3
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number6901330000
Policy instance 4
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number000000000000000
Policy instance 2
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberAG542
Policy instance 1

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