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ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 401k Plan overview

Plan NameROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN
Plan identification number 501

ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

ROGERS POULTRY CO has sponsored the creation of one or more 401k plans.

Company Name:ROGERS POULTRY CO
Employer identification number (EIN):953400340
NAIC Classification:311900
NAIC Description: Other Food Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01KENNETH HAYASHI
5012016-07-01KENNETH HAYASHI KENNETH HAYASHI2017-07-27
5012015-07-01KENNETH HAYASHI KENNETH HAYASHI2017-02-20
5012014-07-01KENNETH HAYASHI
5012013-07-01KENNETH HAYASHI
5012012-07-01KENNETH HAYASHI KENNETH HAYASHI2014-02-20
5012011-07-01KENNETH HAYASHI
5012009-07-01KENNETH HAYASHI

Plan Statistics for ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN

401k plan membership statisitcs for ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN

Measure Date Value
2021: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0190
Total number of active participants reported on line 7a of the Form 55002021-01-0199
Total of all active and inactive participants2021-01-0199
Total participants2021-01-0199
2020: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01125
Total number of active participants reported on line 7a of the Form 55002020-01-0190
Total of all active and inactive participants2020-01-0190
Total participants2020-01-0190
2019: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01121
Total number of active participants reported on line 7a of the Form 55002019-01-01125
Total of all active and inactive participants2019-01-01125
Total participants2019-01-01125
2018: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01117
Total number of active participants reported on line 7a of the Form 55002018-01-01121
Total of all active and inactive participants2018-01-01121
Total participants2018-01-01121
2017: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01116
Total number of active participants reported on line 7a of the Form 55002017-01-01117
Total of all active and inactive participants2017-01-01117
Total participants2017-01-01117
2016: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01123
Total number of active participants reported on line 7a of the Form 55002016-07-01116
Total of all active and inactive participants2016-07-01116
Total participants2016-07-01116
2015: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01127
Total number of active participants reported on line 7a of the Form 55002015-07-01123
Total of all active and inactive participants2015-07-01123
Total participants2015-07-01123
2014: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01121
Total number of active participants reported on line 7a of the Form 55002014-07-01127
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-01127
Number of participants with account balances2014-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
2013: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01121
Total number of active participants reported on line 7a of the Form 55002013-07-01121
Total of all active and inactive participants2013-07-01121
Total participants2013-07-01121
2012: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01121
Total number of active participants reported on line 7a of the Form 55002012-07-01121
Total of all active and inactive participants2012-07-01121
Total participants2012-07-01121
2011: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01131
Total number of active participants reported on line 7a of the Form 55002011-07-01121
Total of all active and inactive participants2011-07-01121
Total participants2011-07-01121
2009: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01149
Total number of active participants reported on line 7a of the Form 55002009-07-01155
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-01155
Number of participants with account balances2009-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010
Number of employers contributing to the scheme2009-07-010

Form 5500 Responses for ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN

2021: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: ROGERS POULTRY CO/UFCW 770 EMPLOYEES HEALTH PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planYes
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number
Policy instance 1
Number of Individuals Covered11
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $45,000
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $941,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,500
Amount paid for insurance broker fees11500
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number
Policy instance 1
Number of Individuals Covered117
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $41,072
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $821,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,804
Insurance broker nameCARLOS MONTERO REYNOSO
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number
Policy instance 1
Number of Individuals Covered123
Insurance policy start date2015-12-01
Insurance policy end date2016-11-30
Total amount of commissions paid to insurance brokerUSD $32,907
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $938,554
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,680
Insurance broker nameCARLOS MONTERO REYNOSO
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number
Policy instance 1
Number of Individuals Covered127
Insurance policy start date2014-12-01
Insurance policy end date2015-12-01
Total amount of commissions paid to insurance brokerUSD $38,593
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $835,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,648
Insurance broker nameCARLOS DONALD REYNOSO
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number
Policy instance 1
Number of Individuals Covered121
Insurance policy start date2013-12-01
Insurance policy end date2014-12-01
Total amount of commissions paid to insurance brokerUSD $37,764
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $755,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,441
Insurance broker nameCARLOS DONALD REYNOSO
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number
Policy instance 1
Number of Individuals Covered121
Insurance policy start date2012-12-01
Insurance policy end date2013-12-01
Total amount of commissions paid to insurance brokerUSD $27,861
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $655,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,896
Insurance broker nameCARLOS M REYNOSO
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number
Policy instance 1
Number of Individuals Covered121
Insurance policy start date2011-12-01
Insurance policy end date2012-12-01
Total amount of commissions paid to insurance brokerUSD $29,487
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $589,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number165443
Policy instance 1
Insurance contract or identification number165443
Number of Individuals Covered155
Insurance policy start date2010-07-01
Insurance policy end date2010-11-30
Total amount of commissions paid to insurance brokerUSD $18,744
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $379,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number
Policy instance 2
Number of Individuals Covered131
Insurance policy start date2010-12-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $25,005
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $438,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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