JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS 401k Plan overview
| Plan Name | JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS |
| Plan identification number | 502 |
JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Health (other than dental or vision)
- Life insurance
- Dental
- Vision
- Death benefits (include travel accident but not life insurance)
|
401k Sponsoring company profile
JACKSONS FOOD STORES, INC has sponsored the creation of one or more 401k plans.
Additional information about JACKSONS FOOD STORES, INC
| Jurisdiction of Incorporation: | Nevada Department of State |
| Incorporation Date: | 1995-10-18 |
| Company Identification Number: | 19951143180 |
| Legal Registered Office Address: |
701 S CARSON ST STE 200
CARSON CITY
United States of America (USA)
89701
|
More information about JACKSONS FOOD STORES, INC
Form 5500 Filing Information
Submission information for form 5500 for 401k plan JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 502 | 2017-06-01 | | | | |
| 502 | 2016-06-01 | | | | |
| 502 | 2015-06-01 | | | | |
Plan Statistics for JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS
401k plan membership statisitcs for JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS
| Measure | Date | Value |
|---|
| 2017: JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-06-01 | 164 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 185 |
| Number of retired or separated participants receiving benefits | 2017-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-06-01 | 0 |
| Total of all active and inactive participants | 2017-06-01 | 185 |
| 2016: JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-06-01 | 164 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 164 |
| Number of retired or separated participants receiving benefits | 2016-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-06-01 | 0 |
| Total of all active and inactive participants | 2016-06-01 | 164 |
| 2015: JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 145 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 147 |
| Number of retired or separated participants receiving benefits | 2015-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 0 |
| Total of all active and inactive participants | 2015-06-01 | 147 |
Form 5500 Responses for JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS
| 2017: JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS 2017 form 5500 responses |
|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | This submission is the final filing | Yes |
| 2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS 2016 form 5500 responses |
|---|
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Submission has been amended | No |
| 2016-06-01 | This submission is the final filing | No |
| 2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-06-01 | Plan is a collectively bargained plan | No |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: JACKSONS EMPLOYEE BENEFIT PLAN, ARIZONA LOCATIONS 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | First time form 5500 has been submitted | Yes |
| 2015-06-01 | Submission has been amended | No |
| 2015-06-01 | This submission is the final filing | No |
| 2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-06-01 | Plan is a collectively bargained plan | No |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 ) |
| Policy contract number | 30135 |
| Policy instance | 1 |
| Insurance contract or identification number | 30135 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $25,175 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $445,004 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,175 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INSURANCE |
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