401k Plan data: HEALTH REIMBURSEMENT ARRANGEMENT plan

HEALTH REIMBURSEMENT ARRANGEMENT 401k Plan overview

Plan Name	HEALTH REIMBURSEMENT ARRANGEMENT
Plan identification number	535

HEALTH REIMBURSEMENT ARRANGEMENT Benefits

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

401k Sponsoring company profile

SAN MIGUEL ELECTRIC CO-OP, INC. has sponsored the creation of one or more 401k plans.

Company Name: SAN MIGUEL ELECTRIC CO-OP, INC.

Employer identification number (EIN): 741937134

NAIC Classification: 221100

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
535 2013-01-01 JANICE CHEW
535 2012-01-01 ALISON YOUNG ALISON YOUNG 2013-03-18
535 2011-01-01 BRIDGET FORD
535 2010-01-01 BRIDGET FORD
535 2009-01-01 BRIDGET FORD
535 2009-01-01 BRIDGET FORD

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
535	2013-01-01	JANICE CHEW
535	2012-01-01	ALISON YOUNG	ALISON YOUNG	2013-03-18
535	2011-01-01	BRIDGET FORD
535	2010-01-01	BRIDGET FORD
535	2009-01-01	BRIDGET FORD
535	2009-01-01	BRIDGET FORD

Plan Statistics for HEALTH REIMBURSEMENT ARRANGEMENT

401k plan membership statisitcs for HEALTH REIMBURSEMENT ARRANGEMENT

Measure Date Value
2013: HEALTH REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year 2013-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 166
Number of retired or separated participants receiving benefits 2013-01-01 12
Total of all active and inactive participants 2013-01-01 178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 179
2012: HEALTH REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year 2012-01-01 184
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 187
Total of all active and inactive participants 2012-01-01 187
Total participants 2012-01-01 187
2011: HEALTH REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year 2011-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 180
Number of retired or separated participants receiving benefits 2011-01-01 4
Total of all active and inactive participants 2011-01-01 184
Total participants 2011-01-01 184
2010: HEALTH REIMBURSEMENT ARRANGEMENT 2010 401k membership
Total participants, beginning-of-year 2010-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 186
Total of all active and inactive participants 2010-01-01 186
Total participants 2010-01-01 186
2009: HEALTH REIMBURSEMENT ARRANGEMENT 2009 401k membership
Total participants, beginning-of-year 2009-01-01 180
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 186
Total of all active and inactive participants 2009-01-01 186
Total participants 2009-01-01 186

Measure	Date	Value
2013: HEALTH REIMBURSEMENT ARRANGEMENT 2013 401k membership
Total participants, beginning-of-year	2013-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	166
Number of retired or separated participants receiving benefits	2013-01-01	12
Total of all active and inactive participants	2013-01-01	178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	179
2012: HEALTH REIMBURSEMENT ARRANGEMENT 2012 401k membership
Total participants, beginning-of-year	2012-01-01	184
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	187
Total of all active and inactive participants	2012-01-01	187
Total participants	2012-01-01	187
2011: HEALTH REIMBURSEMENT ARRANGEMENT 2011 401k membership
Total participants, beginning-of-year	2011-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	180
Number of retired or separated participants receiving benefits	2011-01-01	4
Total of all active and inactive participants	2011-01-01	184
Total participants	2011-01-01	184
2010: HEALTH REIMBURSEMENT ARRANGEMENT 2010 401k membership
Total participants, beginning-of-year	2010-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	186
Total of all active and inactive participants	2010-01-01	186
Total participants	2010-01-01	186
2009: HEALTH REIMBURSEMENT ARRANGEMENT 2009 401k membership
Total participants, beginning-of-year	2009-01-01	180
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	186
Total of all active and inactive participants	2009-01-01	186
Total participants	2009-01-01	186

Form 5500 Responses for HEALTH REIMBURSEMENT ARRANGEMENT

2013: HEALTH REIMBURSEMENT ARRANGEMENT 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
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
2012: HEALTH REIMBURSEMENT ARRANGEMENT 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: HEALTH REIMBURSEMENT ARRANGEMENT 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: HEALTH REIMBURSEMENT ARRANGEMENT 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: HEALTH REIMBURSEMENT ARRANGEMENT 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	SAN MIGUEL ELECTRIC CO-OP, INC.
Employer identification number (EIN):	741937134
NAIC Classification:	221100