401k Plan data: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN plan

MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN
Plan identification number	501

MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

MRS. GREENS MANAGEMENT CORP. has sponsored the creation of one or more 401k plans.

Company Name: MRS. GREENS MANAGEMENT CORP.

Employer identification number (EIN): 134033582

NAIC Classification: 445110
NAIC Description: Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-10-01 LAURA-SUE BOGGI
501 2014-10-01 SUSAN SIERRA
501 2013-10-01 SUSAN SIERRA

Plan id#	Filing Submission Date	Name of Administrator
501	2015-10-01	LAURA-SUE BOGGI
501	2014-10-01	SUSAN SIERRA
501	2013-10-01	SUSAN SIERRA

Plan Statistics for MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN

401k plan membership statisitcs for MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN

Measure Date Value
2015: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 257
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 236
Number of retired or separated participants receiving benefits 2015-10-01 1
Number of other retired or separated participants entitled to future benefits 2015-10-01 0
Total of all active and inactive participants 2015-10-01 237
2014: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 228
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 255
Number of retired or separated participants receiving benefits 2014-10-01 2
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 257
2013: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 214
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 225
Number of retired or separated participants receiving benefits 2013-10-01 3
Number of other retired or separated participants entitled to future benefits 2013-10-01 0
Total of all active and inactive participants 2013-10-01 228

Measure	Date	Value
2015: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	257
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	236
Number of retired or separated participants receiving benefits	2015-10-01	1
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	237
2014: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	228
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	255
Number of retired or separated participants receiving benefits	2014-10-01	2
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	257
2013: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	214
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	225
Number of retired or separated participants receiving benefits	2013-10-01	3
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	228

Form 5500 Responses for MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN

2015: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2014: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2013: MRS. GREEN'S MANAGEMENT CORP. HEALTH & WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	First time form 5500 has been submitted	Yes
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	MRS. GREENS MANAGEMENT CORP.
Employer identification number (EIN):	134033582
NAIC Classification:	445110
NAIC Description:	Supermarkets and Other Grocery (except Convenience) Stores