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| Plan Name | GOODWILL INDUSTRIES OF SOUTH MISSISSIPPI, INC. HEALTH BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GOODWILL INDUSTRIES OF SOUTH MISSISSIPPI, INC. |
| Employer identification number (EIN): | 640547585 |
| NAIC Classification: | 813000 |
| NAIC Description: | Religious, Grantmaking, Civic, Professional, and Similar Organizations |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-01-01 | ||||
| 501 | 2022-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2023: GOODWILL INDUSTRIES OF SOUTH MISSISSIPPI, INC. HEALTH BENEFIT PLAN 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 110 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 110 |
| 2022: GOODWILL INDUSTRIES OF SOUTH MISSISSIPPI, INC. HEALTH BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 136 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 144 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 144 |
| 2023: GOODWILL INDUSTRIES OF SOUTH MISSISSIPPI, INC. HEALTH BENEFIT PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: GOODWILL INDUSTRIES OF SOUTH MISSISSIPPI, INC. HEALTH BENEFIT PLAN 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | First time form 5500 has been submitted | Yes |
| 2022-01-01 | Submission has been amended | Yes |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 045218 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| GULF GUARANTY EMPLOYEE BENEFIT SERVICES, INC (National Association of Insurance Commissioners NAIC id number: 77976 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 1537 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 045218 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| GULF GUARANTY EMPLOYEE BENEFIT SERVICES, INC (National Association of Insurance Commissioners NAIC id number: 77976 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 1537 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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