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| Plan Name | 40 SQUARE ANCILLARY TRUST |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | 40 SQUARE COOPERATIVE SOLUTIONS |
| Employer identification number (EIN): | 823878354 |
| NAIC Classification: | 525100 |
| NAIC Description: | Insurance and Employee Benefit Funds |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-01-01 | ||||
| 501 | 2018-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2019: 40 SQUARE ANCILLARY TRUST 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 312 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 0 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
| Total participants | 2019-01-01 | 0 |
| Number of participants with account balances | 2019-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 0 |
| 2018: 40 SQUARE ANCILLARY TRUST 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 312 |
| Total of all active and inactive participants | 2018-01-01 | 312 |
| Total participants | 2018-01-01 | 312 |
| Number of participants with account balances | 2018-01-01 | 312 |
| 2019: 40 SQUARE ANCILLARY TRUST 2019 form 5500 responses | ||
|---|---|---|
| 2019-01-01 | Type of plan entity | Mulitple employer plan |
| 2019-01-01 | This submission is the final filing | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: 40 SQUARE ANCILLARY TRUST 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Mulitple employer plan |
| 2018-01-01 | First time form 5500 has been submitted | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |||||||||||||||||||||||||||
| Policy contract number | 136-420596 | ||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |||||||||||||||||||||||||||
| Policy contract number | VG 186961 | ||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||
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