401k Plan data: MATTRESS FIRM EMPLOYEE DENTAL PLAN plan

MATTRESS FIRM EMPLOYEE DENTAL PLAN 401k Plan overview

Plan Name	MATTRESS FIRM EMPLOYEE DENTAL PLAN
Plan identification number	503

MATTRESS FIRM EMPLOYEE DENTAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

MATTRESS FIRM INC. has sponsored the creation of one or more 401k plans.

Company Name: MATTRESS FIRM INC.

Employer identification number (EIN): 760596008

NAIC Classification: 442299
NAIC Description: All Other Home Furnishings Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MATTRESS FIRM EMPLOYEE DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2007-09-01 ALEX WEISS 2015-07-01
503 2007-09-01 ALEX WEISS
503 2006-09-01 ALEX WEISS 2015-07-01
503 2006-09-01 ALEX WEISS
503 2005-09-01 ALEX WEISS 2015-07-01
503 2005-09-01 ALEX WEISS

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2007-09-01		ALEX WEISS	2015-07-01
503	2007-09-01	ALEX WEISS
503	2006-09-01		ALEX WEISS	2015-07-01
503	2006-09-01	ALEX WEISS
503	2005-09-01		ALEX WEISS	2015-07-01
503	2005-09-01	ALEX WEISS

Plan Statistics for MATTRESS FIRM EMPLOYEE DENTAL PLAN

401k plan membership statisitcs for MATTRESS FIRM EMPLOYEE DENTAL PLAN

Measure Date Value
2007: MATTRESS FIRM EMPLOYEE DENTAL PLAN 2007 401k membership
Total participants, beginning-of-year 2007-09-01 718
Total number of active participants reported on line 7a of the Form 5500 2007-09-01 0
Number of retired or separated participants receiving benefits 2007-09-01 0
Number of other retired or separated participants entitled to future benefits 2007-09-01 0
Total of all active and inactive participants 2007-09-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-09-01 0
Total participants 2007-09-01 0
Number of participants with account balances 2007-09-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-09-01 0
2006: MATTRESS FIRM EMPLOYEE DENTAL PLAN 2006 401k membership
Total participants, beginning-of-year 2006-09-01 866
Total number of active participants reported on line 7a of the Form 5500 2006-09-01 718
Number of retired or separated participants receiving benefits 2006-09-01 0
Number of other retired or separated participants entitled to future benefits 2006-09-01 0
Total of all active and inactive participants 2006-09-01 718
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2006-09-01 0
Total participants 2006-09-01 718
Number of participants with account balances 2006-09-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2006-09-01 0
2005: MATTRESS FIRM EMPLOYEE DENTAL PLAN 2005 401k membership
Total participants, beginning-of-year 2005-09-01 692
Total number of active participants reported on line 7a of the Form 5500 2005-09-01 866
Number of retired or separated participants receiving benefits 2005-09-01 0
Number of other retired or separated participants entitled to future benefits 2005-09-01 0
Total of all active and inactive participants 2005-09-01 866
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2005-09-01 0
Total participants 2005-09-01 866
Number of participants with account balances 2005-09-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2005-09-01 0

Measure	Date	Value
2007: MATTRESS FIRM EMPLOYEE DENTAL PLAN 2007 401k membership
Total participants, beginning-of-year	2007-09-01	718
Total number of active participants reported on line 7a of the Form 5500	2007-09-01	0
Number of retired or separated participants receiving benefits	2007-09-01	0
Number of other retired or separated participants entitled to future benefits	2007-09-01	0
Total of all active and inactive participants	2007-09-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-09-01	0
Total participants	2007-09-01	0
Number of participants with account balances	2007-09-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-09-01	0
2006: MATTRESS FIRM EMPLOYEE DENTAL PLAN 2006 401k membership
Total participants, beginning-of-year	2006-09-01	866
Total number of active participants reported on line 7a of the Form 5500	2006-09-01	718
Number of retired or separated participants receiving benefits	2006-09-01	0
Number of other retired or separated participants entitled to future benefits	2006-09-01	0
Total of all active and inactive participants	2006-09-01	718
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2006-09-01	0
Total participants	2006-09-01	718
Number of participants with account balances	2006-09-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2006-09-01	0
2005: MATTRESS FIRM EMPLOYEE DENTAL PLAN 2005 401k membership
Total participants, beginning-of-year	2005-09-01	692
Total number of active participants reported on line 7a of the Form 5500	2005-09-01	866
Number of retired or separated participants receiving benefits	2005-09-01	0
Number of other retired or separated participants entitled to future benefits	2005-09-01	0
Total of all active and inactive participants	2005-09-01	866
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2005-09-01	0
Total participants	2005-09-01	866
Number of participants with account balances	2005-09-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2005-09-01	0

Form 5500 Responses for MATTRESS FIRM EMPLOYEE DENTAL PLAN

2007: MATTRESS FIRM EMPLOYEE DENTAL PLAN 2007 form 5500 responses
2007-09-01	Type of plan entity	Single employer plan
2007-09-01	Submission has been amended	No
2007-09-01	This submission is the final filing	Yes
2007-09-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2007-09-01	Plan is a collectively bargained plan	No
2007-09-01	Plan funding arrangement – Insurance	Yes
2007-09-01	Plan benefit arrangement – Insurance	Yes
2006: MATTRESS FIRM EMPLOYEE DENTAL PLAN 2006 form 5500 responses
2006-09-01	Type of plan entity	Single employer plan
2006-09-01	Submission has been amended	No
2006-09-01	This submission is the final filing	No
2006-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-09-01	Plan is a collectively bargained plan	No
2006-09-01	Plan funding arrangement – Insurance	Yes
2006-09-01	Plan benefit arrangement – Insurance	Yes
2005: MATTRESS FIRM EMPLOYEE DENTAL PLAN 2005 form 5500 responses
2005-09-01	Type of plan entity	Single employer plan
2005-09-01	First time form 5500 has been submitted	Yes
2005-09-01	Submission has been amended	No
2005-09-01	This submission is the final filing	No
2005-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2005-09-01	Plan is a collectively bargained plan	No
2005-09-01	Plan funding arrangement – Insurance	Yes
2005-09-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

119057-G

Policy instance

Insurance contract or identification number	119057-G
Number of Individuals Covered	718
Insurance policy start date	2007-09-01
Insurance policy end date	2007-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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 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	No
Dental Insurance Welfare Benefit	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	FRINGE BENEFIT MANAGEMENT, INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

119057-G

Policy instance

Insurance contract or identification number	119057-G
Number of Individuals Covered	1041
Insurance policy start date	2006-09-01
Insurance policy end date	2007-08-31
Total amount of commissions paid to insurance broker	USD $6,978
Total amount of fees paid to insurance company	USD $878
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 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	No
Dental Insurance Welfare Benefit	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $199,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,978
Amount paid for insurance broker fees	878
Insurance broker organization code?	3
Insurance broker name	FRINGE BENEFIT MANAGEMENT, INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

119057-G

Policy instance

Insurance contract or identification number	119057-G
Number of Individuals Covered	866
Insurance policy start date	2005-09-01
Insurance policy end date	2006-08-31
Total amount of commissions paid to insurance broker	USD $5,560
Total amount of fees paid to insurance company	USD $0
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 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	No
Dental Insurance Welfare Benefit	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $163,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,560
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	FRINGE BENEFIT MANAGEMENT, INC.

Potentially related plans

MATTRESS FIRM 401(K) PLAN [EIN = 271014943]

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Company Name:	MATTRESS FIRM INC.
Employer identification number (EIN):	760596008
NAIC Classification:	442299
NAIC Description:	All Other Home Furnishings Stores