401k Plan data: MY FIT FOODS 401(K) PLAN plan

MY FIT FOODS 401(K) PLAN 401k Plan overview

Plan Name	MY FIT FOODS 401(K) PLAN
Plan identification number	001

MY FIT FOODS 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

MY FIT FOODS PAYROLL LLC has sponsored the creation of one or more 401k plans.

Company Name: MY FIT FOODS PAYROLL LLC

Employer identification number (EIN): 272519292

NAIC Classification: 445299
NAIC Description: All Other Specialty Food Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MY FIT FOODS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01 SHAWN BROWN
001 2017-01-01 SHAWN BROWN
001 2016-01-01
001 2015-01-01 MIKE LUBITZ
001 2015-01-01 MIKE LUBITZ
001 2015-01-01
001 2014-01-01 DIEDRE JONES 2015-07-23

Plan Statistics for MY FIT FOODS 401(K) PLAN

401k plan membership statisitcs for MY FIT FOODS 401(K) PLAN

Measure Date Value
2018: MY FIT FOODS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 235
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 0
Number of participants with account balances 2018-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: MY FIT FOODS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 259
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 222
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 13
Total of all active and inactive participants 2017-01-01 235
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 235
Number of participants with account balances 2017-01-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: MY FIT FOODS 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 274
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 237
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 22
Total of all active and inactive participants 2016-01-01 259
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 259
Number of participants with account balances 2016-01-01 45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: MY FIT FOODS 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 298
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 233
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 25
Total of all active and inactive participants 2015-01-01 258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 258
Number of participants with account balances 2015-01-01 51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2018: MY FIT FOODS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	235
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	0
Number of participants with account balances	2018-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: MY FIT FOODS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	259
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	222
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	13
Total of all active and inactive participants	2017-01-01	235
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	235
Number of participants with account balances	2017-01-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: MY FIT FOODS 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	274
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	237
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	22
Total of all active and inactive participants	2016-01-01	259
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	259
Number of participants with account balances	2016-01-01	45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: MY FIT FOODS 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	298
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	233
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	25
Total of all active and inactive participants	2015-01-01	258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	258
Number of participants with account balances	2015-01-01	51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on MY FIT FOODS 401(K) PLAN

Measure	Date	Value
2018 : MY FIT FOODS 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-03-26	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-03-26	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-03-26	$0
Total income from all sources (including contributions)	2018-03-26	$205
Total loss/gain on sale of assets	2018-03-26	$0
Total of all expenses incurred	2018-03-26	$37,777
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-03-26	$37,302
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-03-26	$0
Value of total assets at end of year	2018-03-26	$0
Value of total assets at beginning of year	2018-03-26	$37,572
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-03-26	$475
Total interest from all sources	2018-03-26	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-03-26	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-03-26	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2018-03-26	$0
Was this plan covered by a fidelity bond	2018-03-26	No
If this is an individual account plan, was there a blackout period	2018-03-26	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-03-26	$0
Were there any nonexempt tranactions with any party-in-interest	2018-03-26	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-03-26	No
Value of net income/loss	2018-03-26	$-37,572
Value of net assets at end of year (total assets less liabilities)	2018-03-26	$0
Value of net assets at beginning of year (total assets less liabilities)	2018-03-26	$37,572
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-03-26	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-03-26	No
Were any leases to which the plan was party in default or uncollectible	2018-03-26	No
Value of interest in pooled separate accounts at end of year	2018-03-26	$0
Value of interest in pooled separate accounts at beginning of year	2018-03-26	$37,572
Net investment gain/loss from pooled separate accounts	2018-03-26	$205
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-03-26	No
Was there a failure to transmit to the plan any participant contributions	2018-03-26	No
Has the plan failed to provide any benefit when due under the plan	2018-03-26	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-03-26	$37,302
Contract administrator fees	2018-03-26	$475
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-03-26	No
Did the plan have assets held for investment	2018-03-26	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-03-26	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-03-26	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-03-26	Yes
Opinion of an independent qualified public accountant for this plan	2018-03-26	Disclaimer
Accountancy firm name	2018-03-26	COHN REZNICK
Accountancy firm EIN	2018-03-26	221478099
2017 : MY FIT FOODS 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$24,691
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$160,502
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$152,673
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$6,760
Value of total assets at end of year	2017-12-31	$37,572
Value of total assets at beginning of year	2017-12-31	$173,383
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$7,829
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	No
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$6,760
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-135,811
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$37,572
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$173,383
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$37,572
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$173,383
Net investment gain/loss from pooled separate accounts	2017-12-31	$17,931
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$152,673
Contract administrator fees	2017-12-31	$7,829
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	COHN REZNICK
Accountancy firm EIN	2017-12-31	221478099
2016 : MY FIT FOODS 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$99,998
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$69,770
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$65,100
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$85,953
Value of total assets at end of year	2016-12-31	$173,383
Value of total assets at beginning of year	2016-12-31	$143,155
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$4,670
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$85,953
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$30,228
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$173,383
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$143,155
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$173,383
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$143,155
Net investment gain/loss from pooled separate accounts	2016-12-31	$14,045
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$65,100
Contract administrator fees	2016-12-31	$4,670
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	No
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	COHN REZNICK
Accountancy firm EIN	2016-12-31	221478099
2015 : MY FIT FOODS 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$102,745
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$37,956
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$33,822
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$102,933
Value of total assets at end of year	2015-12-31	$143,155
Value of total assets at beginning of year	2015-12-31	$78,366
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$4,134
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	No
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$102,933
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$64,789
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$143,155
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$78,366
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$143,155
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$78,366
Net investment gain/loss from pooled separate accounts	2015-12-31	$-188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$33,822
Contract administrator fees	2015-12-31	$4,134
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	COHN REZNICK LLP

Form 5500 Responses for MY FIT FOODS 401(K) PLAN

2018: MY FIT FOODS 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	Yes
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: MY FIT FOODS 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: MY FIT FOODS 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: MY FIT FOODS 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

91690770

Policy instance

Insurance contract or identification number	91690770
Number of Individuals Covered	0
Insurance policy start date	2018-01-01
Insurance policy end date	2018-03-26
Total amount of commissions paid to insurance broker	USD $12
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9
Insurance broker organization code?	3
Insurance broker name	DAVIDSON JEFFREY W

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

91690770

Policy instance

Insurance contract or identification number	91690770
Number of Individuals Covered	21
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $132
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $99
Insurance broker organization code?	3
Insurance broker name	DAVIDON JEFFREY W

Potentially related plans

MY FITNESS PAL 401K [EIN = 270208095]

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Company Name:	MY FIT FOODS PAYROLL LLC
Employer identification number (EIN):	272519292
NAIC Classification:	445299
NAIC Description:	All Other Specialty Food Stores

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2018-01-01	SHAWN BROWN
001	2017-01-01	SHAWN BROWN
001	2016-01-01
001	2015-01-01	MIKE LUBITZ
001	2015-01-01	MIKE LUBITZ
001	2015-01-01
001	2014-01-01	DIEDRE JONES	2015-07-23