401k Plan data: HEALTH REIMBURSEMENT ARRANGEMENT plan

HEALTH REIMBURSEMENT ARRANGEMENT 401k Plan overview

Plan Name	HEALTH REIMBURSEMENT ARRANGEMENT
Plan identification number	510

HEALTH REIMBURSEMENT ARRANGEMENT Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Other welfare benefit cover

401k Sponsoring company profile

STAGNARO DISTRIBUTING LLC has sponsored the creation of one or more 401k plans.

Company Name: STAGNARO DISTRIBUTING LLC

Employer identification number (EIN): 261511440

NAIC Classification: 424800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH REIMBURSEMENT ARRANGEMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2017-01-01
510 2016-01-01 STAGNARO (CHAD KAMSTRA)
510 2015-01-01 STAGNARO (CHAD KAMSTRA)
510 2014-01-01 STAGNARO (CHAD KAMSTRA)
510 2013-01-01 STAGNARO (CHAD KAMSTRA)

Plan Statistics for HEALTH REIMBURSEMENT ARRANGEMENT

401k plan membership statisitcs for HEALTH REIMBURSEMENT ARRANGEMENT

Measure Date Value
2017: HEALTH REIMBURSEMENT ARRANGEMENT 2017 401k membership
Total participants, beginning-of-year 2017-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
2016: HEALTH REIMBURSEMENT ARRANGEMENT 2016 401k membership
Total participants, beginning-of-year 2016-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 103
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 103
2015: HEALTH REIMBURSEMENT ARRANGEMENT 2015 401k membership
Total participants, beginning-of-year 2015-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 97
Number of retired or separated participants receiving benefits 2015-01-01 15
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 112
2014: HEALTH REIMBURSEMENT ARRANGEMENT 2014 401k membership
Total participants, beginning-of-year 2014-01-01 101
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 102
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 102
2013: HEALTH REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year 2013-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 107
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 107

Measure	Date	Value
2017: HEALTH REIMBURSEMENT ARRANGEMENT 2017 401k membership
Total participants, beginning-of-year	2017-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
2016: HEALTH REIMBURSEMENT ARRANGEMENT 2016 401k membership
Total participants, beginning-of-year	2016-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	103
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	103
2015: HEALTH REIMBURSEMENT ARRANGEMENT 2015 401k membership
Total participants, beginning-of-year	2015-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	97
Number of retired or separated participants receiving benefits	2015-01-01	15
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	112
2014: HEALTH REIMBURSEMENT ARRANGEMENT 2014 401k membership
Total participants, beginning-of-year	2014-01-01	101
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	102
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	102
2013: HEALTH REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year	2013-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	107
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	107

Form 5500 Responses for HEALTH REIMBURSEMENT ARRANGEMENT

2017: HEALTH REIMBURSEMENT ARRANGEMENT 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This submission is the final filing	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: HEALTH REIMBURSEMENT ARRANGEMENT 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: HEALTH REIMBURSEMENT ARRANGEMENT 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: HEALTH REIMBURSEMENT ARRANGEMENT 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: HEALTH REIMBURSEMENT ARRANGEMENT 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	STAGNARO DISTRIBUTING LLC
Employer identification number (EIN):	261511440
NAIC Classification:	424800

Plan id#	Filing Submission Date	Name of Administrator
510	2017-01-01
510	2016-01-01	STAGNARO (CHAD KAMSTRA)
510	2015-01-01	STAGNARO (CHAD KAMSTRA)
510	2014-01-01	STAGNARO (CHAD KAMSTRA)
510	2013-01-01	STAGNARO (CHAD KAMSTRA)