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| Plan Name | GEORGE'S FAMILY PHARMACY EMPLOYEE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GEORGES FAMILY PHARMACY, INC. |
| Employer identification number (EIN): | 261399118 |
| NAIC Classification: | 446110 |
| NAIC Description: | Pharmacies and Drug Stores |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-02-01 | TAMI SHELTON | 2024-11-06 | ||
| 501 | 2022-02-01 | TAMI SHELTON | 2023-10-17 |
| Measure | Date | Value |
|---|---|---|
| 2023: GEORGE'S FAMILY PHARMACY EMPLOYEE BENEFITS PLAN 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-02-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-02-01 | 90 |
| Number of retired or separated participants receiving benefits | 2023-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-02-01 | 0 |
| Total of all active and inactive participants | 2023-02-01 | 90 |
| Number of employers contributing to the scheme | 2023-02-01 | 0 |
| 2022: GEORGE'S FAMILY PHARMACY EMPLOYEE BENEFITS PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-02-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 138 |
| Number of retired or separated participants receiving benefits | 2022-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-02-01 | 0 |
| Total of all active and inactive participants | 2022-02-01 | 138 |
| Number of employers contributing to the scheme | 2022-02-01 | 0 |
| 2023: GEORGE'S FAMILY PHARMACY EMPLOYEE BENEFITS PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-02-01 | Type of plan entity | Single employer plan |
| 2023-02-01 | Plan funding arrangement – Insurance | Yes |
| 2023-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: GEORGE'S FAMILY PHARMACY EMPLOYEE BENEFITS PLAN 2022 form 5500 responses | ||
| 2022-02-01 | Type of plan entity | Single employer plan |
| 2022-02-01 | First time form 5500 has been submitted | Yes |
| 2022-02-01 | Plan funding arrangement – Insurance | Yes |
| 2022-02-01 | Plan benefit arrangement – Insurance | Yes |
| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) | |||||||||||||||||||||||||||||
| Policy contract number | L02485 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |||||||||||||||||||||||||||||
| Policy contract number | 953133 | ||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||
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| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||
| Policy contract number | L02485 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |||||||||||||||||||||||||||||
| Policy contract number | 953133 | ||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||||||||||||||
| Policy contract number | G00612668 | ||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||
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