401k Plan data: UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN plan

UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN
Plan identification number	501

UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

UNITED STATES PLAYING CARD COMPANY has sponsored the creation of one or more 401k plans.

Company Name: UNITED STATES PLAYING CARD COMPANY

Employer identification number (EIN): 311421130

NAIC Classification: 339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 DAVID RUSSELL 2021-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-01-01	DAVID RUSSELL	2021-10-13

Plan Statistics for UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN

Measure Date Value
2020: UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
Number of employers contributing to the scheme 2020-01-01 0

Measure	Date	Value
2020: UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
Number of employers contributing to the scheme	2020-01-01	0

Form 5500 Responses for UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN

2020: UNITED STATES PLAYING CARD CO EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	This submission is the final filing	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )

Policy contract number

KY2414

Policy instance

Insurance contract or identification number	KY2414
Number of Individuals Covered	449
Insurance policy start date	2020-02-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $130,763
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,616,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $130,763
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

Potentially related plans

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Company Name:	UNITED STATES PLAYING CARD COMPANY
Employer identification number (EIN):	311421130
NAIC Classification:	339900