401k Plan data: GROUP TRAVEL ACCIDENT PLAN plan

GROUP TRAVEL ACCIDENT PLAN 401k Plan overview

Plan Name	GROUP TRAVEL ACCIDENT PLAN
Plan identification number	505

GROUP TRAVEL ACCIDENT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Death benefits (include travel accident but not life insurance) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

MAIDENFORM, INC. has sponsored the creation of one or more 401k plans.

Company Name: MAIDENFORM, INC.

Employer identification number (EIN): 660201882

NAIC Classification: 424300

Additional information about MAIDENFORM, INC.

Jurisdiction of Incorporation: Vermont Secretary of State Corporations Division

Incorporation Date: 1991-07-23

Company Identification Number: 62301

Legal Registered Office Address: 100 NORTH MAIN STREET
SUITE 2
BARRE
United States of America (USA)
05641

More information about MAIDENFORM, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP TRAVEL ACCIDENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2013-02-01 SETH BOYARSKY JOHN NELSON 2014-06-27
505 2012-02-01 SETH BOYARSKY ROBIN COSTA 2013-07-30
505 2011-02-01 SETH BOYARSKY JOHN NELSON 2012-10-18
505 2009-02-01 ADELE STAVISH MATT ARGANO 2011-01-31

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
505	2013-02-01	SETH BOYARSKY	JOHN NELSON	2014-06-27
505	2012-02-01	SETH BOYARSKY	ROBIN COSTA	2013-07-30
505	2011-02-01	SETH BOYARSKY	JOHN NELSON	2012-10-18
505	2009-02-01	ADELE STAVISH	MATT ARGANO	2011-01-31

Plan Statistics for GROUP TRAVEL ACCIDENT PLAN

401k plan membership statisitcs for GROUP TRAVEL ACCIDENT PLAN

Measure Date Value
2013: GROUP TRAVEL ACCIDENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-02-01 1,315
Total number of active participants reported on line 7a of the Form 5500 2013-02-01 59
Total of all active and inactive participants 2013-02-01 59
2012: GROUP TRAVEL ACCIDENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-02-01 1,357
Total number of active participants reported on line 7a of the Form 5500 2012-02-01 1,315
Total of all active and inactive participants 2012-02-01 1,315
2011: GROUP TRAVEL ACCIDENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-02-01 1,371
Total number of active participants reported on line 7a of the Form 5500 2011-02-01 1,357
Total of all active and inactive participants 2011-02-01 1,357
2009: GROUP TRAVEL ACCIDENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-02-01 1,189
Total number of active participants reported on line 7a of the Form 5500 2009-02-01 1,131
Number of retired or separated participants receiving benefits 2009-02-01 0
Number of other retired or separated participants entitled to future benefits 2009-02-01 0
Total of all active and inactive participants 2009-02-01 1,131
Total participants 2009-02-01 1,131

Measure	Date	Value
2013: GROUP TRAVEL ACCIDENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-02-01	1,315
Total number of active participants reported on line 7a of the Form 5500	2013-02-01	59
Total of all active and inactive participants	2013-02-01	59
2012: GROUP TRAVEL ACCIDENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-02-01	1,357
Total number of active participants reported on line 7a of the Form 5500	2012-02-01	1,315
Total of all active and inactive participants	2012-02-01	1,315
2011: GROUP TRAVEL ACCIDENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-02-01	1,371
Total number of active participants reported on line 7a of the Form 5500	2011-02-01	1,357
Total of all active and inactive participants	2011-02-01	1,357
2009: GROUP TRAVEL ACCIDENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-02-01	1,189
Total number of active participants reported on line 7a of the Form 5500	2009-02-01	1,131
Number of retired or separated participants receiving benefits	2009-02-01	0
Number of other retired or separated participants entitled to future benefits	2009-02-01	0
Total of all active and inactive participants	2009-02-01	1,131
Total participants	2009-02-01	1,131

Form 5500 Responses for GROUP TRAVEL ACCIDENT PLAN

2013: GROUP TRAVEL ACCIDENT PLAN 2013 form 5500 responses
2013-02-01	Type of plan entity	Single employer plan
2013-02-01	Submission has been amended	No
2013-02-01	This submission is the final filing	No
2013-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-02-01	Plan is a collectively bargained plan	No
2013-02-01	Plan funding arrangement – Insurance	Yes
2013-02-01	Plan benefit arrangement – Insurance	Yes
2012: GROUP TRAVEL ACCIDENT PLAN 2012 form 5500 responses
2012-02-01	Type of plan entity	Single employer plan
2012-02-01	Submission has been amended	No
2012-02-01	This submission is the final filing	No
2012-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-02-01	Plan is a collectively bargained plan	No
2012-02-01	Plan funding arrangement – Insurance	Yes
2012-02-01	Plan benefit arrangement – Insurance	Yes
2011: GROUP TRAVEL ACCIDENT PLAN 2011 form 5500 responses
2011-02-01	Type of plan entity	Single employer plan
2011-02-01	Submission has been amended	No
2011-02-01	This submission is the final filing	No
2011-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-02-01	Plan is a collectively bargained plan	No
2011-02-01	Plan funding arrangement – Insurance	Yes
2011-02-01	Plan benefit arrangement – Insurance	Yes
2009: GROUP TRAVEL ACCIDENT PLAN 2009 form 5500 responses
2009-02-01	Type of plan entity	Single employer plan
2009-02-01	Submission has been amended	No
2009-02-01	This submission is the final filing	No
2009-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-02-01	Plan is a collectively bargained plan	No
2009-02-01	Plan funding arrangement – Insurance	Yes
2009-02-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	MAIDENFORM, INC.
Employer identification number (EIN):	660201882
NAIC Classification:	424300

Jurisdiction of Incorporation:	Vermont Secretary of State Corporations Division
Incorporation Date:	1991-07-23
Company Identification Number:	62301
Legal Registered Office Address:	100 NORTH MAIN STREET SUITE 2 BARRE United States of America (USA) 05641