401k Plan data: MSR-FSR LLC EMPLOYEE BENEFIT PLAN plan

MSR-FSR LLC EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	MSR-FSR LLC EMPLOYEE BENEFIT PLAN
Plan identification number	501

MSR-FSR LLC EMPLOYEE BENEFIT 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 Other welfare benefit cover

401k Sponsoring company profile

MSR- FSR, LLC has sponsored the creation of one or more 401k plans.

Company Name: MSR- FSR, LLC

Employer identification number (EIN): 270715061

NAIC Classification: 811210
NAIC Description: Electronic and Precision Equipment Repair and Maintenance

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MSR-FSR LLC EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-10-01
501 2021-10-01 MISSY BRALEY
501 2020-10-01
501 2019-10-01
501 2016-10-01 MISSY BRALEY
501 2015-10-01 MISSY BRALEY

Plan Statistics for MSR-FSR LLC EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for MSR-FSR LLC EMPLOYEE BENEFIT PLAN

Measure Date Value
2021: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-10-01 306
Total number of active participants reported on line 7a of the Form 5500 2021-10-01 280
Number of retired or separated participants receiving benefits 2021-10-01 3
Total of all active and inactive participants 2021-10-01 283
Total participants 2021-10-01 283
2020: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-10-01 317
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 303
Number of retired or separated participants receiving benefits 2020-10-01 3
Number of other retired or separated participants entitled to future benefits 2020-10-01 0
Total of all active and inactive participants 2020-10-01 306
Total participants 2020-10-01 306
2019: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-10-01 221
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 315
Number of retired or separated participants receiving benefits 2019-10-01 2
Number of other retired or separated participants entitled to future benefits 2019-10-01 0
Total of all active and inactive participants 2019-10-01 317
Total participants 2019-10-01 317
2016: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 104
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 97
Number of retired or separated participants receiving benefits 2016-10-01 2
Total of all active and inactive participants 2016-10-01 99
Total participants 2016-10-01 99
2015: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 100
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 104
Total of all active and inactive participants 2015-10-01 104
Total participants 2015-10-01 104

Measure	Date	Value
2021: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-10-01	306
Total number of active participants reported on line 7a of the Form 5500	2021-10-01	280
Number of retired or separated participants receiving benefits	2021-10-01	3
Total of all active and inactive participants	2021-10-01	283
Total participants	2021-10-01	283
2020: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-10-01	317
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	303
Number of retired or separated participants receiving benefits	2020-10-01	3
Number of other retired or separated participants entitled to future benefits	2020-10-01	0
Total of all active and inactive participants	2020-10-01	306
Total participants	2020-10-01	306
2019: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-10-01	221
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	315
Number of retired or separated participants receiving benefits	2019-10-01	2
Number of other retired or separated participants entitled to future benefits	2019-10-01	0
Total of all active and inactive participants	2019-10-01	317
Total participants	2019-10-01	317
2016: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	104
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	97
Number of retired or separated participants receiving benefits	2016-10-01	2
Total of all active and inactive participants	2016-10-01	99
Total participants	2016-10-01	99
2015: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	100
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	104
Total of all active and inactive participants	2015-10-01	104
Total participants	2015-10-01	104

Form 5500 Responses for MSR-FSR LLC EMPLOYEE BENEFIT PLAN

2021: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
2021-10-01	Submission has been amended	No
2021-10-01	This submission is the final filing	Yes
2021-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-10-01	Plan is a collectively bargained plan	No
2021-10-01	Plan funding arrangement – Insurance	Yes
2021-10-01	Plan benefit arrangement – Insurance	Yes
2020: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Submission has been amended	No
2020-10-01	This submission is the final filing	No
2020-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-10-01	Plan is a collectively bargained plan	No
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2019: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Submission has been amended	No
2019-10-01	This submission is the final filing	No
2019-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-10-01	Plan is a collectively bargained plan	No
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2016: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2015: MSR-FSR LLC EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000BLMT
Policy instance	3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	036454
Policy instance	2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	0106183
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000BLMT
Policy instance	3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	036454
Policy instance	2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	0106183
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000BLMT
Policy instance	3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	0106183
Policy instance	2
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	036454
Policy instance	1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	241199
Policy instance	3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	30790-1185
Policy instance	2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	80456398
Policy instance	1

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Company Name:	MSR- FSR, LLC
Employer identification number (EIN):	270715061
NAIC Classification:	811210
NAIC Description:	Electronic and Precision Equipment Repair and Maintenance

Plan id#	Filing Submission Date	Name of Administrator
501	2021-10-01
501	2021-10-01	MISSY BRALEY
501	2020-10-01
501	2019-10-01
501	2016-10-01	MISSY BRALEY
501	2015-10-01	MISSY BRALEY