401k Plan data: PANINI AMERICA, INC. plan

PANINI AMERICA, INC. 401k Plan overview

Plan Name	PANINI AMERICA, INC.
Plan identification number	501

PANINI AMERICA, INC. Benefits

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

401k Sponsoring company profile

PANINI AMERICA INC has sponsored the creation of one or more 401k plans.

Company Name: PANINI AMERICA INC

Employer identification number (EIN): 800326887

NAIC Classification: 451110
NAIC Description: Sporting Goods Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PANINI AMERICA, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-05-01 TERRY LUNA 2024-11-16
501 2022-05-01 TERRY LUNA 2023-11-29
501 2021-05-01 TERRY LUNA 2022-11-08
501 2020-05-01 ROBERT HUU 2021-09-14
501 2017-05-01
501 2016-05-01 TERRY LUNA
501 2015-05-01 TERRY LUNA
501 2014-05-01 TERRY LUNA
501 2013-05-01 TERRY LUNA

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-05-01	TERRY LUNA	2024-11-16
501	2022-05-01	TERRY LUNA	2023-11-29
501	2021-05-01	TERRY LUNA	2022-11-08
501	2020-05-01	ROBERT HUU	2021-09-14
501	2017-05-01
501	2016-05-01	TERRY LUNA
501	2015-05-01	TERRY LUNA
501	2014-05-01	TERRY LUNA
501	2013-05-01	TERRY LUNA

Plan Statistics for PANINI AMERICA, INC.

401k plan membership statisitcs for PANINI AMERICA, INC.

Measure Date Value
2023: PANINI AMERICA, INC. 2023 401k membership
Total participants, beginning-of-year 2023-05-01 214
Total number of active participants reported on line 7a of the Form 5500 2023-05-01 239
Total of all active and inactive participants 2023-05-01 239
2022: PANINI AMERICA, INC. 2022 401k membership
Total participants, beginning-of-year 2022-05-01 218
Total number of active participants reported on line 7a of the Form 5500 2022-05-01 214
Total of all active and inactive participants 2022-05-01 214
2021: PANINI AMERICA, INC. 2021 401k membership
Total participants, beginning-of-year 2021-05-01 186
Total number of active participants reported on line 7a of the Form 5500 2021-05-01 218
Total of all active and inactive participants 2021-05-01 218
2020: PANINI AMERICA, INC. 2020 401k membership
Total participants, beginning-of-year 2020-05-01 176
Total number of active participants reported on line 7a of the Form 5500 2020-05-01 186
Total of all active and inactive participants 2020-05-01 186
Total participants 2020-05-01 186
2017: PANINI AMERICA, INC. 2017 401k membership
Total participants, beginning-of-year 2017-05-01 167
Total number of active participants reported on line 7a of the Form 5500 2017-05-01 173
Total of all active and inactive participants 2017-05-01 173
Total participants 2017-05-01 173
2016: PANINI AMERICA, INC. 2016 401k membership
Total participants, beginning-of-year 2016-05-01 146
Total number of active participants reported on line 7a of the Form 5500 2016-05-01 167
Total of all active and inactive participants 2016-05-01 167
2015: PANINI AMERICA, INC. 2015 401k membership
Total participants, beginning-of-year 2015-05-01 115
Total number of active participants reported on line 7a of the Form 5500 2015-05-01 146
Total of all active and inactive participants 2015-05-01 146
Total participants 2015-05-01 0
2014: PANINI AMERICA, INC. 2014 401k membership
Total participants, beginning-of-year 2014-05-01 115
Total number of active participants reported on line 7a of the Form 5500 2014-05-01 115
Number of retired or separated participants receiving benefits 2014-05-01 3
Total of all active and inactive participants 2014-05-01 118
Total participants 2014-05-01 0
2013: PANINI AMERICA, INC. 2013 401k membership
Total participants, beginning-of-year 2013-05-01 115
Total number of active participants reported on line 7a of the Form 5500 2013-05-01 115
Number of retired or separated participants receiving benefits 2013-05-01 1
Total of all active and inactive participants 2013-05-01 116
Total participants 2013-05-01 0

Measure	Date	Value
2023: PANINI AMERICA, INC. 2023 401k membership
Total participants, beginning-of-year	2023-05-01	214
Total number of active participants reported on line 7a of the Form 5500	2023-05-01	239
Total of all active and inactive participants	2023-05-01	239
2022: PANINI AMERICA, INC. 2022 401k membership
Total participants, beginning-of-year	2022-05-01	218
Total number of active participants reported on line 7a of the Form 5500	2022-05-01	214
Total of all active and inactive participants	2022-05-01	214
2021: PANINI AMERICA, INC. 2021 401k membership
Total participants, beginning-of-year	2021-05-01	186
Total number of active participants reported on line 7a of the Form 5500	2021-05-01	218
Total of all active and inactive participants	2021-05-01	218
2020: PANINI AMERICA, INC. 2020 401k membership
Total participants, beginning-of-year	2020-05-01	176
Total number of active participants reported on line 7a of the Form 5500	2020-05-01	186
Total of all active and inactive participants	2020-05-01	186
Total participants	2020-05-01	186
2017: PANINI AMERICA, INC. 2017 401k membership
Total participants, beginning-of-year	2017-05-01	167
Total number of active participants reported on line 7a of the Form 5500	2017-05-01	173
Total of all active and inactive participants	2017-05-01	173
Total participants	2017-05-01	173
2016: PANINI AMERICA, INC. 2016 401k membership
Total participants, beginning-of-year	2016-05-01	146
Total number of active participants reported on line 7a of the Form 5500	2016-05-01	167
Total of all active and inactive participants	2016-05-01	167
2015: PANINI AMERICA, INC. 2015 401k membership
Total participants, beginning-of-year	2015-05-01	115
Total number of active participants reported on line 7a of the Form 5500	2015-05-01	146
Total of all active and inactive participants	2015-05-01	146
Total participants	2015-05-01	0
2014: PANINI AMERICA, INC. 2014 401k membership
Total participants, beginning-of-year	2014-05-01	115
Total number of active participants reported on line 7a of the Form 5500	2014-05-01	115
Number of retired or separated participants receiving benefits	2014-05-01	3
Total of all active and inactive participants	2014-05-01	118
Total participants	2014-05-01	0
2013: PANINI AMERICA, INC. 2013 401k membership
Total participants, beginning-of-year	2013-05-01	115
Total number of active participants reported on line 7a of the Form 5500	2013-05-01	115
Number of retired or separated participants receiving benefits	2013-05-01	1
Total of all active and inactive participants	2013-05-01	116
Total participants	2013-05-01	0

Form 5500 Responses for PANINI AMERICA, INC.

2023: PANINI AMERICA, INC. 2023 form 5500 responses
2023-05-01	Type of plan entity	Single employer plan
2023-05-01	Plan funding arrangement – Insurance	Yes
2023-05-01	Plan benefit arrangement – Insurance	Yes
2022: PANINI AMERICA, INC. 2022 form 5500 responses
2022-05-01	Type of plan entity	Single employer plan
2022-05-01	Plan funding arrangement – Insurance	Yes
2022-05-01	Plan benefit arrangement – Insurance	Yes
2021: PANINI AMERICA, INC. 2021 form 5500 responses
2021-05-01	Type of plan entity	Single employer plan
2021-05-01	Plan funding arrangement – Insurance	Yes
2021-05-01	Plan benefit arrangement – Insurance	Yes
2020: PANINI AMERICA, INC. 2020 form 5500 responses
2020-05-01	Type of plan entity	Single employer plan
2020-05-01	Plan funding arrangement – Insurance	Yes
2020-05-01	Plan benefit arrangement – Insurance	Yes
2017: PANINI AMERICA, INC. 2017 form 5500 responses
2017-05-01	Type of plan entity	Single employer plan
2017-05-01	Plan funding arrangement – Insurance	Yes
2017-05-01	Plan benefit arrangement – Insurance	Yes
2016: PANINI AMERICA, INC. 2016 form 5500 responses
2016-05-01	Type of plan entity	Single employer plan
2016-05-01	Plan funding arrangement – Insurance	Yes
2016-05-01	Plan benefit arrangement – Insurance	Yes
2015: PANINI AMERICA, INC. 2015 form 5500 responses
2015-05-01	Type of plan entity	Single employer plan
2015-05-01	Plan funding arrangement – Insurance	Yes
2015-05-01	Plan benefit arrangement – Insurance	Yes
2014: PANINI AMERICA, INC. 2014 form 5500 responses
2014-05-01	Type of plan entity	Single employer plan
2014-05-01	Plan funding arrangement – Insurance	Yes
2014-05-01	Plan benefit arrangement – Insurance	Yes
2013: PANINI AMERICA, INC. 2013 form 5500 responses
2013-05-01	Type of plan entity	Single employer plan
2013-05-01	First time form 5500 has been submitted	Yes
2013-05-01	Plan funding arrangement – Insurance	Yes
2013-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

199900

Policy instance

Insurance contract or identification number	199900
Number of Individuals Covered	384
Insurance policy start date	2023-05-01
Insurance policy end date	2024-04-30
Total amount of commissions paid to insurance broker	USD $88,689
Total amount of fees paid to insurance company	USD $2,424
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,994,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

E6210

Policy instance

Insurance contract or identification number	E6210
Number of Individuals Covered	55
Insurance policy start date	2023-05-01
Insurance policy end date	2024-04-30
Total amount of commissions paid to insurance broker	USD $8,589
Total amount of fees paid to insurance company	USD $200
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $57,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00526759

Policy instance

Insurance contract or identification number	00526759
Number of Individuals Covered	239
Insurance policy start date	2023-05-01
Insurance policy end date	2024-04-30
Total amount of commissions paid to insurance broker	USD $45,766
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $381,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

199900

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

E6210

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00526759

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00526759

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

E6210

Policy instance

BLUE CROSS BLUE SHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

199900

Policy instance

BLUE CROSS BLUE SHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

199900

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00526759

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

E6210

Policy instance

BLUE CROSS BLUE SHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

199900

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00526759

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

E6210

Policy instance

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

Policy contract number

KM05917052

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

E6210

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

526265

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

526265

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

E6210

Policy instance

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

Policy contract number

KM05917052

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010069441

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010090675

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00358155

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

E6210

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

526265

Policy instance

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Company Name:	PANINI AMERICA INC
Employer identification number (EIN):	800326887
NAIC Classification:	451110
NAIC Description:	Sporting Goods Stores