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CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 401k Plan overview

Plan NameCJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN
Plan identification number 504

CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

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

Company Name:CJSD HOLDINGS, INC.
Employer identification number (EIN):205876029
NAIC Classification:445120
NAIC Description:Convenience Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042023-01-01LESLEY SEGADELLI2024-10-09
5042022-01-01LESLEY SEGADELLI2023-08-28
5042021-01-01LESLEY SEGADELLI2022-07-21
5042020-01-01SANDY BOLINSKE2021-06-28
5042019-01-01SANDY BOLINSKE2020-07-29
5042018-01-01SANDY BOLINSKE2019-06-17
5042017-01-01
5042016-01-01

Plan Statistics for CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN

401k plan membership statisitcs for CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN

Measure Date Value
2023: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01167
Total number of active participants reported on line 7a of the Form 55002023-01-01292
Total of all active and inactive participants2023-01-01292
2022: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01230
Total number of active participants reported on line 7a of the Form 55002022-01-01167
Total of all active and inactive participants2022-01-01167
2021: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01264
Total number of active participants reported on line 7a of the Form 55002021-01-01229
Number of retired or separated participants receiving benefits2021-01-011
Total of all active and inactive participants2021-01-01230
2020: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01237
Total number of active participants reported on line 7a of the Form 55002020-01-01264
Number of retired or separated participants receiving benefits2020-01-011
Total of all active and inactive participants2020-01-01265
2019: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01274
Total number of active participants reported on line 7a of the Form 55002019-01-01236
Number of retired or separated participants receiving benefits2019-01-011
Total of all active and inactive participants2019-01-01237
2018: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01210
Total number of active participants reported on line 7a of the Form 55002018-01-01274
Total of all active and inactive participants2018-01-01274
2017: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01318
Total number of active participants reported on line 7a of the Form 55002017-01-01210
Total of all active and inactive participants2017-01-01210
2016: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-010
Total number of active participants reported on line 7a of the Form 55002016-01-01318
Total of all active and inactive participants2016-01-01318

Form 5500 Responses for CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN

2023: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: CJSD HOLDINGS INC MEC/MVP HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EMPLOYEE BENEFIT CONSULTANTS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number217104
Policy instance 1
Insurance contract or identification number217104
Number of Individuals Covered292
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $9,848
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMPLOYEE BENEFIT CONSULTANTS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number217104
Policy instance 1
Insurance contract or identification number217104
Number of Individuals Covered167
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $7,328
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4885
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
EMPLOYEE BENEFIT CONSULTANTS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number217104
Policy instance 1
Insurance contract or identification number217104
Number of Individuals Covered229
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $8,277
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5518
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
EMPLOYEE BENEFIT CONSULTANTS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number217104
Policy instance 1
Insurance contract or identification number217104
Number of Individuals Covered264
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $9,717
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6478
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
EMPLOYEE BENEFIT CONSULTANTS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number217104
Policy instance 1
Insurance contract or identification number217104
Number of Individuals Covered236
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $7,938
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees7938
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?3
EMPLOYEE BENEFIT CONSULTANTS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number217104
Policy instance 1
Insurance contract or identification number217104
Number of Individuals Covered274
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,495
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4495
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?3
EMPLOYEE BENEFIT CONSULTANTS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number217104
Policy instance 1
Insurance contract or identification number217104
Number of Individuals Covered238
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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